Remigio-Baker Rosemay A, Hayes Donald K, Reyes-Salvail Florentina
Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0725, La Jolla, CA, 92093-0725, USA,
Matern Child Health J. 2014 Dec;18(10):2300-8. doi: 10.1007/s10995-013-1374-y.
Research on the association between adverse childhood events (ACEs) and depression among women in Hawaii is scarce. ACEs have been linked to unfavorable health behaviors such as smoking and binge drinking which are more prevalent in the state compared to the US overall. The concomitant presence of ACEs with smoking or binge drinking may explain the excess depression prevalence in Hawaii compared to the national average. Using data of women residing in the state (2010 Hawaii Behavioral Risk Factor Surveillance System Survey), we examined the association between ACEs count or type (household dysfunction and physical, verbal and sexual abuse) and current depressive symptoms (CDS), in addition to modification by current smoking status (smoked >100 cigarettes in a lifetime and currently smoke) and binge drinking (consumed ≥4 alcoholic beverage within the past month and in ≥1 occasion(s)). Evaluation of ACEs before age 18 consisted of 11 indicators. Eight indicators of the Patient Health Questionnaire (PHQ-8) were used to assess CDS. All analyses utilized logistic regression taking into account sampling design. The odds ratio of having CDS between those with versus without ACEs increased per increasing number of ACEs (1 ACE: OR = 2.11, CI = 1.16-3.81; 2 ACEs: OR = 2.90, CI = 1.51-5.58; 3 or 4 ACEs: OR = 3.94, CI = 2.13-7.32; 5+ ACEs: OR = 4.04, CI = 2.26-7.22). Household dysfunction (OR = 2.10, CI = 1.37-3.23), physical abuse (OR = 1.67, CI = 1.08-2.59), verbal abuse (OR = 3.21, CI = 2.03-5.09) and sexual abuse (OR = 1.68, CI = 1.04-2.71) were all positively associated with CDS. Verbal abuse had the strongest magnitude of association. Neither current smoking status nor binge drinking modified the relationship between ACEs count (or type) and CDS. In conclusion, the presence of ACEs among women in Hawaii was indicative of CDS in adulthood, notably verbal abuse. Further, a dose response existed between the number of ACEs and the odds for CDS. The concomitant exposure to ACEs and current smoking status or binge drinking did not elevate odds for CDS.
关于夏威夷女性童年不良经历（ACEs）与抑郁症之间关联的研究很少。ACEs与吸烟和酗酒等不良健康行为有关，与美国总体情况相比，这些行为在该州更为普遍。ACEs与吸烟或酗酒同时存在，可能解释了夏威夷抑郁症患病率高于全国平均水平的原因。利用该州女性的数据（2010年夏威夷行为风险因素监测系统调查），我们研究了ACEs的数量或类型（家庭功能障碍以及身体、言语和性虐待）与当前抑郁症状（CDS）之间的关联，此外还研究了当前吸烟状况（一生吸烟超过100支且目前仍在吸烟）和酗酒（在过去一个月内≥4次饮用酒精饮料且≥1次）对这种关联的影响。对18岁之前ACEs的评估由11项指标组成。使用患者健康问卷（PHQ - 8）的8项指标来评估CDS。所有分析均采用逻辑回归，并考虑了抽样设计。与没有ACEs的人相比，有ACEs的人出现CDS的比值比随着ACEs数量的增加而升高（1次ACE：OR = 2.11，CI = 1.16 - 3. .81；2次ACE：OR = 2.90，CI = 1.51 - 5.58；3次或4次ACE：OR = 3.94，CI = 2.13 - 7.32；5次及以上ACE：OR = 4.04，CI = 2.26 - 7.22）。家庭功能障碍（OR = 2.10，CI = 1.37 - 3.23）、身体虐待（OR = 1.67，CI = 1.08 - 2.59）、言语虐待（OR = 3.21，CI = 2.03 - 5.09）和性虐待（OR = 1.68，CI = 1.04 - 2.71）均与CDS呈正相关。言语虐待的关联强度最大。当前吸烟状况和酗酒均未改变ACEs数量（或类型）与CDS之间的关系。总之，夏威夷女性中ACEs的存在表明成年后会出现CDS，尤其是言语虐待。此外，ACEs的数量与CDS的几率之间存在剂量反应关系。同时暴露于ACEs以及当前吸烟状况或酗酒并未增加CDS的几率。
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