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日本儿童期逆境与精神障碍首发的相关性:来自世界心理健康日本项目,2002-2004 年的结果。

Association of childhood adversities with the first onset of mental disorders in Japan: results from the World Mental Health Japan, 2002-2004.

机构信息

Section of Behavioral Science, Department of Health Promotion National Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama 351-0197, Japan.

出版信息

J Psychiatr Res. 2011 Apr;45(4):481-7. doi: 10.1016/j.jpsychires.2010.08.002. Epub 2010 Aug 21.

Abstract

It is well known that childhood adversities (CAs) are a significant risk factor for mental disorders in later life. However, it is uncertain whether a similar association between CAs and mental disorders can be found in Japan. Few studies have employed an appropriate statistical model that takes into account the high comorbidity of CAs. The purpose of this study is to elucidate the association between CAs and the onset of mental disorders in Japan. We used the data from the World Mental Health Japan, 2002-2004 (n=1722). Respondents completed diagnostic interviews (the World Health Organization Composite International Diagnostic Interview) that assessed lifetime prevalence of 15 Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV) disorders. Associations of 12 retrospectively reported CAs with the lifetime prevalence of mental disorders were estimated using discrete-time survival analysis. Of the study sample, 32% reported as having experienced at least 1 CA during childhood. The studied CAs were highly comorbid. Parental mental illness showed significant sub-additive effects. The presence of 3 CAs showed a significant interactive effect on any mental health disorder. The number of CAs had a strong interactive effect on the onset of anxiety disorders. Predictive effects of CAs were found only among childhood onset mental disorders. It was confirmed that CAs are one of predictors of the onset of DSM-IV mental disorders, especially during childhood, in Japan.

摘要

众所周知,儿童逆境(CA)是晚年精神障碍的一个重要危险因素。然而,在日本,CA 是否与精神障碍之间存在类似的关联尚不确定。很少有研究采用适当的统计模型来考虑 CA 的高度共病性。本研究旨在阐明日本 CA 与精神障碍发病之间的关联。我们使用了 2002-2004 年世界心理健康日本(World Mental Health Japan,2002-2004)的数据(n=1722)。受访者完成了诊断访谈(世界卫生组织综合国际诊断访谈),评估了 15 种《精神障碍诊断与统计手册》第四版(DSM-IV)障碍的终身患病率。使用离散时间生存分析估计了 12 种回顾性报告的 CA 与精神障碍终身患病率之间的关联。在研究样本中,32%的人报告在儿童时期至少经历过 1 次 CA。研究中的 CA 高度共病。父母的精神疾病显示出显著的亚加性效应。3 种 CA 的存在对任何心理健康障碍都有显著的交互作用。CA 的数量对焦虑障碍的发病有很强的交互作用。CA 的预测作用仅在儿童期发病的精神障碍中得到证实。证实 CA 是 DSM-IV 精神障碍发病的预测因素之一,尤其是在日本的儿童时期。

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