School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia.
School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia; The University of Queensland Centre for Clinical Research, Herston, Queensland, Australia.
Child Abuse Negl. 2019 Oct;96:104082. doi: 10.1016/j.chiabu.2019.104082. Epub 2019 Jul 30.
Child maltreatment is a global public health issue that encompasses physical abuse, sexual abuse, emotional abuse, neglect, and exposure to intimate partner violence (IPV). This systematic review and meta-analysis summarises the association between these five forms of child maltreatment and depressive and anxiety disorders.
Published cohort and case-control studies were included if they reported associations between any form of child maltreatment (and/or a combination of), and depressive and anxiety disorders. A total of 604 studies were assessed for eligibility, 106 met inclusion criteria, and 96 were included in meta-analyses. The data were pooled in random effects meta-analyses, giving odds ratios (ORs) with corresponding 95% confidence intervals (CIs) for each form of child maltreatment.
All forms of child maltreatment were associated with depressive disorders (any child maltreatment [OR = 2.48, 2.14-2.87]; sexual abuse [OR = 2.11, 1.83-2.44]; physical abuse [OR = 1.78, 1.57-2.01]; emotional abuse [OR = 2.35, 1.74-3.18]; neglect [OR = 1.65, 1.35-2.02]; and exposure to IPV [OR = 1.68, 1.34-2.10]). Several forms of child maltreatment were significantly associated with anxiety disorders ('any child maltreatment' [OR = 1.68, 1.33-2.4]; sexual abuse [OR = 1.90, 1.6-2.25]; physical abuse [OR = 1.56, 1.39-1.76]; and neglect [OR = 1.34, 1.09-1.65]). Significant associations were also found between several forms of child maltreatment and post-traumatic stress disorder (PTSD).
There is a robust association between five forms of child maltreatment and the development of mental disorders. The Global Burden of Disease Study (GBD) includes only sexual abuse as a risk factor for depressive and anxiety disorders. These findings support the inclusion of additional forms of child maltreatment as risk factors in GBD.
儿童虐待是一个全球性的公共卫生问题，包括身体虐待、性虐待、情感虐待、忽视以及亲密伴侣暴力（IPV）的暴露。本系统评价和荟萃分析总结了这五种形式的儿童虐待与抑郁和焦虑障碍之间的关联。
如果队列研究和病例对照研究报告了任何形式的儿童虐待（和/或组合）与抑郁和焦虑障碍之间的关联，则将其纳入评估。共有 604 项研究进行了资格评估，其中 106 项符合纳入标准，96 项纳入荟萃分析。采用随机效应荟萃分析汇总数据，为每种形式的儿童虐待提供比值比（OR）及其相应的 95%置信区间（CI）。
所有形式的儿童虐待均与抑郁障碍相关（任何儿童虐待[OR=2.48，2.14-2.87]；性虐待[OR=2.11，1.83-2.44]；身体虐待[OR=1.78，1.57-2.01]；情感虐待[OR=2.35，1.74-3.18]；忽视[OR=1.65，1.35-2.02]；以及 IPV 的暴露[OR=1.68，1.34-2.10]）。几种形式的儿童虐待与焦虑障碍显著相关（“任何儿童虐待”[OR=1.68，1.33-2.4]；性虐待[OR=1.90，1.6-2.25]；身体虐待[OR=1.56，1.39-1.76]；以及忽视[OR=1.34，1.09-1.65]）。几种形式的儿童虐待与创伤后应激障碍（PTSD）之间也存在显著关联。
五种形式的儿童虐待与精神障碍的发生之间存在强有力的关联。全球疾病负担研究（GBD）仅将性虐待作为抑郁和焦虑障碍的一个风险因素。这些发现支持将其他形式的儿童虐待作为 GBD 的风险因素纳入其中。
Zotero 插件