Neuropsychiatric Research Institute, Sanford Neuroscience Clinic, Fargo, North Dakota; University of North Dakota, Grand Forks, North Dakota; Fargo VA Healthcare System, Fargo, North Dakota.
University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania.
Surg Obes Relat Dis. 2019 Feb;15(2):295-303. doi: 10.1016/j.soard.2018.11.009. Epub 2018 Nov 15.
A history of childhood maltreatment and psychopathology are common in adults with obesity.
To report childhood maltreatment and to evaluate associations between severity and type of childhood maltreatment and lifetime history of psychopathology among adults with severe obesity awaiting bariatric surgery.
Four clinical centers of the Longitudinal Assessment of Bariatric Surgery Research Consortium.
The Childhood Trauma Questionnaire, which assesses presence/severity (i.e., none, mild, moderate, severe) of physical abuse, mental abuse, physical neglect, mental neglect, and sexual abuse, was completed by 302 female and 66 male bariatric surgery patients. Presurgery lifetime history of psychopathology and suicidal ideation/behavior were assessed with the Structured Clinical Interview for DSM-IV and the Suicidal Behavioral Questionnaire-Revised, respectively. Presurgery lifetime history of antidepressant use was self-reported.
Two thirds (66.6%) of females and 47.0% of males reported at least 1 form of childhood trauma; 42.4% and 24.2%, respectively, at greater than or equal to moderate severity. Among women, presence/greater severity of childhood mental or physical abuse or neglect was associated with a higher risk of history of psychopathology (i.e., major depressive disorder, posttraumatic stress disorder, other anxiety disorder, alcohol use disorder, binge eating disorder), suicidal ideation/behavior and antidepressant use (P for all ≤ .02). These associations were independent of age, race, education, body mass index, and childhood sexual abuse. Childhood sexual abuse was independently associated with a history of suicidal ideation/behavior and antidepressant use only (P for both ≤ .05). Statistical power was limited to evaluate these associations among men.
Among women with obesity, presence/severity of childhood trauma was positively associated with relatively common psychiatric disorders.
儿童期虐待和精神病理学在肥胖成年人中很常见。
报告儿童虐待情况，并评估严重肥胖患者中儿童期虐待的严重程度和类型与终生精神病理学史之间的关系，这些患者正在接受减重手术。
肥胖与代谢外科治疗纵向评估研究联盟的四个临床中心。
通过肥胖与代谢外科治疗纵向评估研究联盟的四个临床中心，302 名女性和 66 名男性接受减重手术的患者完成了儿童创伤问卷，该问卷评估身体虐待、精神虐待、身体忽视、精神忽视和性虐待的存在/严重程度（即无、轻度、中度、重度）。使用 DSM-IV 结构化临床访谈和修订后的自杀行为问卷分别评估术前终生精神病理学史和自杀意念/行为。术前使用抗抑郁药的情况由患者自我报告。
66.6%的女性和 47.0%的男性报告至少有一种形式的儿童创伤；分别有 42.4%和 24.2%的人报告了中度或以上严重程度的创伤。在女性中，存在/更严重的儿童期心理或身体虐待或忽视与精神病理学史（即重度抑郁症、创伤后应激障碍、其他焦虑障碍、酒精使用障碍、暴食障碍）、自杀意念/行为和抗抑郁药使用的风险增加相关（所有 P 值均≤.02）。这些关联独立于年龄、种族、教育、体重指数和儿童期性虐待。儿童期性虐待仅与自杀意念/行为和抗抑郁药使用史独立相关（两者的 P 值均≤.05）。评估男性中这些关联的统计能力有限。
在肥胖女性中，儿童期创伤的存在/严重程度与相对常见的精神障碍呈正相关。
