Koola Maju Mathew, Qualls Clifford, Kelly Deanna L, Skelton Kelly, Bradley Bekh, Amar Richard, Duncan Erica J
Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA.
J Nerv Ment Dis. 2013 Apr;201(4):348-52. doi: 10.1097/NMD.0b013e318288e333.
We examined the prevalence of childhood (≤ 18 years) physical and sexual abuse reported among patients admitted to the psychiatric inpatient service and the differential rates of this abuse associated with psychiatric diagnoses. This study consisted of a retrospective chart review of 603 patients admitted to a psychiatric ward during a period of 1 year at Atlanta Veterans Affairs Medical Center who had data on childhood physical and sexual abuse. The prevalence of reported childhood physical or sexual abuse in this inpatient clinical population was 19.4% (117/603). The prevalence of reported physical abuse was 22.6% (19/84) in the women and 12.0% (62/519) in the men (p = 0.008); the prevalence of sexual abuse was 33.3% (28/84) in the women and 7.7% (40/519) in the men (p < 0.0001). More patients with depressive disorders reported sexual abuse than did those without these disorders. More patients with posttraumatic stress disorder (PTSD) reported physical and sexual abuse than did those without these disorders. Stratifying by race, sex, and diagnoses, multivariate analyses showed that the women with PTSD had a greater likelihood to report physical abuse (p = 0.03) and sexual abuse histories (p = 0.008) than did the women without PTSD. The men with substance-induced mood disorder (p = 0.01) were more likely to report physical abuse compared with the men without substance-induced mood disorder. Screening for abuse in patients with depressive disorders and PTSD is warranted to tailor individualized treatments for these patients. More research is needed to better understand the potential implications of childhood abuse on psychiatric diagnoses.
我们调查了入住精神科住院部的患者中报告的儿童期（≤18岁）身体虐待和性虐待的患病率，以及与精神疾病诊断相关的这种虐待的差异率。本研究包括对亚特兰大退伍军人事务医疗中心1年内入住精神科病房的603例患者进行回顾性病历审查，这些患者有儿童期身体和性虐待的数据。在这个住院临床人群中，报告的儿童期身体或性虐待的患病率为19.4%（117/603）。报告的身体虐待患病率在女性中为22.6%（19/84），在男性中为12.0%（62/519）（p = 0.008）；性虐待患病率在女性中为33.3%（28/84），在男性中为7.7%（40/519）（p < 0.0001）。与没有抑郁症的患者相比，更多患有抑郁症的患者报告了性虐待。与没有创伤后应激障碍（PTSD）的患者相比，更多患有创伤后应激障碍的患者报告了身体和性虐待。按种族、性别和诊断进行分层，多变量分析显示，患有PTSD的女性比没有PTSD的女性更有可能报告身体虐待（p = 0.03）和性虐待史（p = 0.008）。与没有物质所致情绪障碍的男性相比，患有物质所致情绪障碍的男性（p = 0.01）更有可能报告身体虐待。对患有抑郁症和PTSD的患者进行虐待筛查，有助于为这些患者量身定制个体化治疗。需要更多的研究来更好地理解儿童期虐待对精神疾病诊断的潜在影响。
