Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain.
Soc Psychiatry Psychiatr Epidemiol. 2013 Mar;48(3):371-84. doi: 10.1007/s00127-012-0550-5. Epub 2012 Aug 8.
Childhood adversities (CAs) have consistently been associated with mental health problems in childhood and adulthood. However, few studies have employed appropriate statistical methods that take into account overlap among CAs, and many of the ones that did so were based on insufficiently complex models. The present paper studies the prevalence of a wide variety of CAs, as well as their relationship to the onset of mental disorders in a representative sample of a Spanish population.
The study is part of the ESEMeD-Spain project, a cross-sectional household survey, which included a nationally representative sample of the Spanish adult population. CAs' associations with lifetime prevalence of mental disorders were estimated using discrete-time survival analysis with person-years as the unit of analysis.
Of our sample, 20.6% reported at least one CA, of whom 24% reported more than one CA. Parental death, parental mental disorder, family violence, economic adversity, physical and sexual abuse were associated with different groups of mental disorders. CAs were associated with the onset of mental disorders during several stages of life. Simulations suggest that CAs were associated with 12.6% of all disorders, 10.8% of mood disorders, 5.8% of anxiety disorders, 27% of substance disorders and 29.7% of externalising disorders.
Prevalences of CAs in the Spanish population are lower than those found in other high-income countries, especially when compared to the USA. In Spain, different CAs were associated with the onset of a number of mental disorders, although these associations were not as frequent as in other countries. Although lower than in other countries, the association between CAs and mental health in Spain should be considered relevant. Specific health policies and prevention programmes are needed in order to decrease this burden.
童年逆境（CA）一直与儿童期和成年期的心理健康问题相关。然而，很少有研究采用适当的统计方法来考虑 CA 之间的重叠，并且其中许多研究都是基于不够复杂的模型。本研究旨在研究广泛的 CA 发生率，以及它们与西班牙代表性人群中精神障碍发病的关系。
该研究是 ESEMeD-Spain 项目的一部分，这是一项横断面家庭调查，包括了西班牙成年人口的全国代表性样本。使用离散时间生存分析，以人年为分析单位，估计 CA 与终生精神障碍患病率之间的关联。
在我们的样本中，20.6%的人报告至少有一种 CA，其中 24%的人报告了多种 CA。父母死亡、父母精神障碍、家庭暴力、经济逆境、身体和性虐待与不同组别的精神障碍相关。CA 与一生中多个阶段的精神障碍发病相关。模拟表明，CA 与所有障碍的 12.6%、心境障碍的 10.8%、焦虑障碍的 5.8%、物质使用障碍的 27%和外化障碍的 29.7%相关。
西班牙人群中的 CA 发生率低于其他高收入国家，尤其是与美国相比。在西班牙，不同的 CA 与多种精神障碍的发病相关，尽管这些关联不如其他国家那么频繁。尽管低于其他国家，但西班牙 CA 与精神健康之间的关联仍应被视为相关。需要制定具体的卫生政策和预防计划来减少这一负担。
