School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Schizophr Bull. 2017 Sep 1;43(5):1045-1055. doi: 10.1093/schbul/sbw175.
Child maltreatment is a widespread public health problem associated with a range of mental health disorders later in life. In order to effectively address these disorders, there is a need to understand more about the mental health consequences of different types of child maltreatment. This study examines the associations between prospectively substantiated child maltreatment (ages 0-14 y) and reports of hallucinations and delusional experiences at 21 years after birth. As well, we examined 12-month and lifetime psychotic disorders using data from a longitudinal birth cohort. The study comprised 3752 participants from the Mater-University of Queensland Study of Pregnancy, a prospective Australian prebirth cohort study. Psychotic experiences and 12-month and lifetime psychosis were measured using the Achenbach Young Adults Self-Report, the Peter's Delusions Inventory, and Composite International Diagnostic Interview at the 21-year follow-up. In adjusted analyses, those children who had experienced any maltreatment and who were emotionally abused and neglected were more likely to report (1) hallucinations and lifetime delusional experiences and (2) more likely to experience lifetime psychosis than their nonabused counterparts. In expanded models, those exposed to multiple forms of maltreatment, in particular with emotional abuse and neglect, had an increased likelihood of hallucinations and delusional experiences. There is an association between child maltreatment, especially emotional abuse and neglect, and later hallucinations, delusional experiences, and psychosis. It is, however, relevant to note that the vast majority of children experiencing childhood maltreatment do not appear to develop psychotic experiences or psychotic disorder. Further research to determine the reasons for highly variable outcomes of child maltreatment is warranted.
儿童虐待是一个普遍存在的公共卫生问题，与日后一系列心理健康障碍有关。为了有效解决这些障碍，我们需要更深入地了解不同类型的儿童虐待对心理健康的影响。本研究调查了前瞻性证实的儿童虐待（0-14 岁）与 21 岁时出现幻觉和妄想体验之间的关联。此外，我们还利用纵向出生队列的数据，研究了 12 个月和终生精神病障碍。该研究包括来自 Mater-昆士兰大学妊娠研究的 3752 名参与者，这是一项前瞻性澳大利亚产前队列研究。使用 Achenbach 青少年自我报告、Peter's 妄想量表和综合国际诊断访谈，在 21 岁的随访中测量了精神病体验和 12 个月和终生精神病。在调整分析中，那些经历过任何虐待、遭受情感虐待和忽视的儿童更有可能报告（1）幻觉和终生妄想体验，以及（2）终生精神病，而不是他们未受虐待的同龄人。在扩展模型中，那些暴露于多种形式的虐待，特别是情感虐待和忽视的儿童，更有可能出现幻觉和妄想体验。儿童虐待，尤其是情感虐待和忽视，与日后的幻觉、妄想体验和精神病之间存在关联。然而，需要注意的是，绝大多数经历过儿童虐待的儿童似乎并未出现精神病体验或精神病障碍。有必要进一步研究导致儿童虐待结果高度可变的原因。
