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[初级保健中成年咨询患者童年不良经历与抑郁症之间的关联]

[Association between adverse childhood experiences with depression in adults consulting in primary care].

作者信息

Vitriol Verónica, Cancino Alfredo, Leiva-Bianchi Marcelo, Serrano Carlos, Ballesteros Soledad, Potthoff Soledad, Cáceres Cristián, Ormazábal Marcela, Asenjo Andrea

机构信息

Escuela de Medicina, Universidad de Talca, Chile.

Escuela de Psicología, Universidad de Talca, Chile.

出版信息

Rev Med Chil. 2017 Sep;145(9):1145-1153. doi: 10.4067/s0034-98872017000901145.

Abstract

BACKGROUND

Traumatic experiences during childhood may influence the development of mental disorders during adulthood.

AIM

To determine clinical and psychosocial variables that are associated with a higher frequency of adverse childhood experiences (ACE) in patients who consult for depression in Primary Health Care clinics in Chile.

MATERIAL AND METHODS

A socio-demographic interview, the mini international neuropsychiatric interview (MINI), a screening for ACE, a questionnaire for partner violence (PV), the Life Experiences Survey (LES) and the Hamilton Rating Scale for Depression (HRDS) were applied to 394 patients with major depression (87% women).

RESULTS

Eighty two percent of patients had experienced at least one ACE and 43% of them reported three or more. Positive correlations were observed between the number of ACE and severity of depressive symptoms (r = 0.19; p < 0.01), psychiatric comorbidities (r = 0.23; p < 0.01), partner violence events (r = 0.31; p < 0.01), vital stressful events (r = 0.12; p < 0.01), number of depressive episodes (r = 0.16; p < 0.01), duration of the longer depressive episode (r = 0.12; p < 0.05) and suicidal tendency according to HDRS (r = 0.16; p < 0.01). An inverse correlation was observed between frequency of ACE and age at the first depressive episode (r = -0.12; p < 0.05).

CONCLUSIONS

These data are consistent with the hypothesis that early trauma is associated with more severe and complex depressive episodes during adulthood.

摘要

背景

童年时期的创伤经历可能会影响成年后精神障碍的发展。

目的

确定智利初级卫生保健诊所中因抑郁症就诊的患者中,与较高频率的童年不良经历(ACE)相关的临床和社会心理变量。

材料与方法

对394名重度抑郁症患者(87%为女性)进行了社会人口学访谈、迷你国际神经精神病学访谈(MINI)、ACE筛查、伴侣暴力问卷调查(PV)、生活经历调查(LES)以及汉密尔顿抑郁评定量表(HRDS)。

结果

82%的患者至少经历过一次ACE,其中43%报告有三次或更多次。ACE的数量与抑郁症状的严重程度(r = 0.19;p < 0.01)、精神共病(r = 0.23;p < 0.01)、伴侣暴力事件(r = 0.31;p < 0.01)、重要应激事件(r = 0.12;p < 0.01)、抑郁发作次数(r = 0.16;p < 0.01)、最长抑郁发作的持续时间(r = 0.12;p < 0.05)以及根据HRDS得出的自杀倾向(r = 0.16;p < 0.01)之间存在正相关。ACE的频率与首次抑郁发作时的年龄之间存在负相关(r = -0.12;p < 0.05)。

结论

这些数据与早期创伤与成年期更严重、更复杂的抑郁发作相关的假设一致。

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