Nakai Yukiei, Inoue Takeshi, Toda Hiroyuki, Toyomaki Atsuhito, Nakato Yasuya, Nakagawa Shin, Kitaichi Yuji, Kameyama Rie, Hayashishita Yoshiyuki, Wakatsuki Yumi, Oba Koji, Tanabe Hajime, Kusumi Ichiro
Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan.
Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan.
J Affect Disord. 2014 Apr;158:101-7. doi: 10.1016/j.jad.2014.02.004. Epub 2014 Feb 10.
Previous studies have shown the interaction between heredity and childhood stress or life events on the pathogenesis of major depression. We hypothesized that childhood abuse, affective temperaments, and adult stressful life events interact and influence depressive symptoms in the general adult population and tested this hypothesis in this study.
The 294 participants from the nonclinical general adult population were studied using the following self-administered questionnaire surveys: the Patient Health Questionnaire-9 (PHQ-9), Life Experiences Survey (LES), Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego auto-questionnaire (TEMPS-A), and Child Abuse and Trauma Scale (CATS). The data were analyzed with single and multiple regressions and structural equation modeling (Amos 20.0).
Childhood abuse indirectly predicted the severity of the depressive symptoms through affective temperaments measured by TEMPS-A in the structural equation modeling. Four temperaments - depressive, cyclothymic, irritable, and anxious - directly predicted the severity of depressive symptoms and the negative appraisal of life events during the past year. The negative appraisal of life events during the past year mildly, but significantly, predicted the severity of depressive symptoms.
The subjects of this study were nonclinical. The findings might not be generalized to patients with mood disorders.
This study suggests that childhood abuse, especially neglect, indirectly increased depressive symptoms through increased affective temperaments, which, in turn, increase the negative appraisal of stressful life events. An important role of affective temperaments in the effect of childhood abuse and stressful life events on depressive symptoms was suggested.
既往研究表明，遗传因素与童年期应激或生活事件在重度抑郁症的发病机制中存在相互作用。我们假设童年期虐待、情感气质和成人应激性生活事件相互作用并影响一般成年人群的抑郁症状，并在本研究中对这一假设进行了检验。
使用以下自填式问卷调查对294名来自非临床一般成年人群的参与者进行了研究：患者健康问卷-9（PHQ-9）、生活经历调查（LES）、孟菲斯、比萨、巴黎和圣地亚哥气质自评问卷（TEMPS-A）以及儿童虐待与创伤量表（CATS）。采用单因素和多因素回归分析以及结构方程模型（Amos 20.0）对数据进行分析。
在结构方程模型中，童年期虐待通过TEMPS-A所测量的情感气质间接预测抑郁症状的严重程度。四种气质类型——抑郁型、环性心境型、易怒型和焦虑型——直接预测抑郁症状的严重程度以及过去一年生活事件的负面评价。过去一年生活事件的负面评价轻度但显著地预测了抑郁症状的严重程度。
本研究的受试者为非临床人群。研究结果可能无法推广至心境障碍患者。
本研究表明，童年期虐待，尤其是忽视，通过增加情感气质间接增加了抑郁症状，而情感气质反过来又增加了对应激性生活事件的负面评价。研究提示情感气质在童年期虐待和应激性生活事件对抑郁症状的影响中起重要作用。
