Department of Behavioural Sciences, University of Helsinki, PO Box 9, FI-00014 Helsinki, Finland.
J Psychiatr Res. 2011 Mar;45(3):332-8. doi: 10.1016/j.jpsychires.2010.07.003. Epub 2010 Jul 24.
In a large, prospective epidemiological study we tested whether exposure to severe early life stress increases the risk of severe mental disorders in adulthood, and whether childhood socioeconomic background and sex modify these associations. Among the 12,747 participants of the Helsinki Birth Cohort Study, born 1934-1944, 1719 were recorded as separated temporarily from their parents in childhood. The separations took place during World War II when Finnish children were voluntarily evacuated unaccompanied by their parents to temporary foster care abroad (mean age at and length of separation 4.6 and 1.7 years, respectively). Severe mental disorders were identified from the Finnish Hospital Discharge and Causes of Death Registers between years 1969 and 2004. Compared to the non-separated, the separated had higher risks of mental, substance use and personality disorder (P-values ≤ 0.05). The risk of any mental and substance use disorder was, however, highest in the separated and lowest in the non-separated with an upper childhood socioeconomic background; individuals with a lower childhood socioeconomic background showed an intermediate risk regardless of their separation status (P-values for interactions ≤ 0.05). Temporary separation from parents poses a risk of severe mental disorders later in life. Children with an upper childhood socioeconomic background may be particularly sensitive to this type of early life stress, while for children with a lower childhood socioeconomic background it may not add to the risk already associated with lower socioeconomic position in childhood.
在一项大型前瞻性流行病学研究中，我们测试了严重的早期生活压力是否会增加成年后患严重精神障碍的风险，以及儿童社会经济背景和性别是否会改变这些关联。在 1934 年至 1944 年出生的赫尔辛基出生队列研究的 12747 名参与者中，有 1719 人被记录为在童年时暂时与父母分开。这些分离发生在第二次世界大战期间，当时芬兰儿童在没有父母陪伴的情况下自愿被疏散到国外临时寄养（平均年龄和分离时间分别为 4.6 岁和 1.7 岁）。严重精神障碍是根据 1969 年至 2004 年期间芬兰住院和死因登记册确定的。与未分离的人相比，分离的人患精神障碍、物质使用障碍和人格障碍的风险更高（P 值≤0.05）。然而，任何精神和物质使用障碍的风险在分离和非分离的人中最高，具有较高的童年社会经济背景；无论其分离状态如何，具有较低童年社会经济背景的个体都表现出中等风险（交互作用的 P 值≤0.05）。与父母暂时分离会增加晚年患严重精神障碍的风险。具有较高童年社会经济背景的儿童可能对此类早期生活压力特别敏感，而对于童年社会经济地位较低的儿童，这种压力可能不会增加与童年时期较低社会经济地位相关的风险。
