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压力与成年期抑郁和重度饮酒的发展:儿童期创伤的调节作用。

Stress and development of depression and heavy drinking in adulthood: moderating effects of childhood trauma.

机构信息

School of Public Health, University of Alberta, Edmonton, Canada.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2013 Feb;48(2):265-74. doi: 10.1007/s00127-012-0531-8. Epub 2012 Jun 9.

Abstract

PURPOSE

Studies suggest that childhood trauma is linked to both depression and heavy drinking in adulthood, and may create a lifelong vulnerability to stress. Few studies have explored the effects of stress sensitization on the development of depression or heavy drinking among those who have experienced traumatic childhood events. This study aimed to determine the effect of childhood trauma on the odds of experiencing depression or heavy drinking in the face of an adult life stressor, using a large population-based Canadian cohort.

METHODS

A total of 3,930 participants were included from the National Population Health Survey. The associations among childhood trauma, recent stress and depression/heavy drinking from 1994/1995 to 2008/2009 were explored using logistic regression, as were interactions between childhood trauma and recent stress. A generalized linear mixed model was used to determine the effects of childhood trauma and stressful events on depression/heavy drinking. Analyses were stratified by sex.

RESULTS

Childhood trauma significantly increased the odds of becoming depressed (following 1 event: OR = 1.66; 95%CI 1.01, 2.71; 2+ events, OR = 3.89; 95%CI 2.44, 6.22) and drinking heavily (2+ events: OR = 1.79; 95%CI 1.03, 3.13). Recent stressful events were associated with depression, but not heavy drinking. While most interaction terms were not significant, in 2004/2005 the association between recent stress and depression was stronger in those who reported childhood trauma compared to those with no childhood trauma.

CONCLUSIONS

Childhood trauma increases risk for both depression and heavy drinking. Trauma may moderate the effect of stress on depression; the relationship among trauma, stress and heavy drinking is less clear.

摘要

目的

研究表明,儿童时期遭受创伤与成年后患抑郁症和酗酒有关,并可能使人终生易受压力影响。很少有研究探讨应激敏感对经历过创伤性儿童事件的人发展为抑郁症或酗酒的影响。本研究旨在使用大型基于人群的加拿大队列来确定儿童创伤对在面临成年生活应激源时经历抑郁或酗酒的可能性的影响。

方法

从全国人口健康调查中纳入了 3930 名参与者。使用逻辑回归探讨了儿童创伤、近期压力与 1994/1995 年至 2008/2009 年期间抑郁/酗酒之间的关联,以及儿童创伤与近期压力之间的相互作用。使用广义线性混合模型来确定儿童创伤和应激事件对抑郁/酗酒的影响。按性别分层分析。

结果

儿童创伤显著增加了抑郁的可能性(发生 1 次事件:OR=1.66;95%CI 1.01,2.71;2 次及以上事件:OR=3.89;95%CI 2.44,6.22)和酗酒的可能性(2 次及以上事件:OR=1.79;95%CI 1.03,3.13)。近期应激事件与抑郁有关,但与酗酒无关。虽然大多数交互项不显著,但在 2004/2005 年,与无儿童创伤的人相比,报告儿童创伤的人近期压力与抑郁之间的关联更强。

结论

儿童创伤会增加患抑郁症和酗酒的风险。创伤可能会调节压力对抑郁的影响;创伤、压力和酗酒之间的关系不太清楚。

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