儿童期性虐待与中国女性复发性重度抑郁的发生发展。
Childhood sexual abuse and the development of recurrent major depression in Chinese women.
机构信息
Huashan Hospital of Fudan University, Shanghai, People's Republic of China.
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
出版信息
PLoS One. 2014 Jan 29;9(1):e87569. doi: 10.1371/journal.pone.0087569. eCollection 2014.
BACKGROUND
Our prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set?
METHOD
Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression.
RESULTS
We confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19-5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58-3.15), genital (OR 5.24, 95% CI 3.52-8.15) and intercourse (OR 10.65, 95% CI 5.56-23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11-2.27) and phobia (OR 1.41, 95%CI 1.09-1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20-1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02-2.02). Intercourse (OR 3.47, 95%CI 1.66-8.22), use of force and threats (OR 1.95, 95%CI 1.05-3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20-1.64) were significantly associated with recurrent MD.
CONCLUSIONS
In Chinese women CSA is strongly associated with recurrent MD and this association increases with greater severity of CSA. Depressed women with CSA have some specific clinical traits. Some features of CSA were associated with greater likelihood of developing recurrent MD.
背景
我们之前的研究表明，曾遭受过儿童期性虐待（CSA）的汉族女性发生重度抑郁症（MD）的风险增加。这种关系是否也存在于我们的全部数据集中？
方法
通过自我报告，在两组汉族女性中评估了 CSA 的三个级别（非生殖器、生殖器和性交）：6017 例经临床确诊的复发性 MD 患者和 5983 例匹配的对照。通过个人访谈评估诊断和其他风险因素信息。通过逻辑回归计算比值比（OR）。
结果
我们通过复制复发性 MD 的新病例 3950 例来证实之前的结果。这两个数据集之间没有显著差异。任何形式的 CSA 均与复发性 MD 显著相关（OR 4.06，95%置信区间（CI）[3.19-5.24]）。这种关联随着 CSA 严重程度的增加而增强：非生殖器（OR 2.21，95%CI 1.58-3.15）、生殖器（OR 5.24，95%CI 3.52-8.15）和性交（OR 10.65，95%CI 5.56-23.71）。在抑郁女性中，那些有 CSA 的人发病年龄更早，抑郁发作时间更长。有 CSA 的复发性 MD 患者患心境恶劣障碍（OR 1.60，95%CI 1.11-2.27）和恐惧症（OR 1.41，95%CI 1.09-1.80）的风险增加。任何形式的 CSA 均与自杀意念或企图（OR 1.50，95%CI 1.20-1.89）和无价值感或内疚感（OR 1.41，95%CI 1.02-2.02）显著相关。性交（OR 3.47，95%CI 1.66-8.22）、使用武力和威胁（OR 1.95，95%CI 1.05-3.82）以及受害者当时受到的影响程度（OR 1.39，95%CI 1.20-1.64）与复发性 MD 显著相关。
结论
在中国女性中，CSA 与复发性 MD 密切相关，这种关联随着 CSA 严重程度的增加而增强。有 CSA 的抑郁女性具有一些特定的临床特征。CSA 的一些特征与更有可能发生复发性 MD 有关。
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