Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
J Affect Disord. 2013 May;147(1-3):241-6. doi: 10.1016/j.jad.2012.11.010. Epub 2012 Nov 26.
Little is known about the role of childhood abuse in late-life depression. The aim of the study is therefore to study whether childhood abuse is associated with late-life depression according to its onset, and which clinical characteristics play a role in this association.
Data were used from 378 depressed and 132 non-depressed persons, aged 60-93 years, from the Netherlands Study of Depression in Older persons (NESDO). Childhood abuse included psychological, physical and sexual abuse and emotional neglect.
53% of the depressed older adults reported childhood abuse, compared to 16% of the non-depressed older adults (p<0.001). Using logistic regression analyses adjusted for age, sex and level of education, depression was strongest associated with physical abuse (Odds Ratio ((OR) 13.71; 95% Confidence Interval (CI) 3.25-57.91) and least with sexual abuse (OR 5.35; 95% CI 2.36-12.14). Childhood abuse was associated with early-onset (OR 13.73, 95% CI 7.31-25.80), middle age-onset (OR 5.36, 95% CI 2.90-9.90) and late-onset depression (OR 4.74, 95% CI 2.51-8.95). In the late-onset group childhood abuse was associated with an increased number of chronic diseases.
Age of depression onset and childhood abuse were asked retrospectively, which may have biased the results.
Childhood abuse is strongly related to late-life depression and its comorbidities, even in the case of late-onset depression. This might suggest that psychological wellbeing can be maintained throughout middle age, but may be disturbed in later life.
对于儿童期虐待在晚年抑郁症中的作用知之甚少。因此,本研究旨在根据发病情况研究儿童期虐待是否与晚年抑郁症有关,以及哪些临床特征在这种关联中起作用。
本研究使用了来自荷兰老年人抑郁研究(NESDO)的 378 名抑郁和 132 名非抑郁老年人的数据。儿童期虐待包括心理、身体和性虐待以及情感忽视。
53%的老年抑郁症患者报告有儿童期虐待,而非老年抑郁症患者为 16%(p<0.001)。使用调整年龄、性别和教育程度的逻辑回归分析,抑郁与身体虐待的关联最强(优势比(OR)13.71;95%置信区间(CI)3.25-57.91),与性虐待的关联最弱(OR 5.35;95%CI 2.36-12.14)。儿童期虐待与早发性(OR 13.73,95%CI 7.31-25.80)、中年发病(OR 5.36,95%CI 2.90-9.90)和晚发性抑郁(OR 4.74,95%CI 2.51-8.95)有关。在晚发性发病组中,儿童期虐待与更多的慢性疾病有关。
抑郁发病年龄和儿童期虐待是回顾性询问的,这可能会使结果产生偏差。
儿童期虐待与晚年抑郁症及其合并症密切相关,即使是在晚发性抑郁症的情况下也是如此。这可能表明心理健康可以在中年期保持,但在晚年可能会受到干扰。