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韧性作为儿童期创伤与心境障碍关系的中介因素:一项针对年轻成年人的社区样本研究。

Resilience as a mediator factor in the relationship between childhood trauma and mood disorder: A community sample of young adults.

机构信息

Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brasil.

Translational Science on Brain Disorders, Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, RS, Brasil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.

出版信息

J Affect Disord. 2020 Sep 1;274:48-53. doi: 10.1016/j.jad.2020.04.011. Epub 2020 May 1.

Abstract

BACKGROUND

Studies on the field of mood disorders has mainly focusing on the risk factors associated to develop the illness or the clinical factors associated with the clinical progression. Less attention was given to factors such as resilience that may be associated with better outcomes in the course of mood disorders. In this study, we assessed the mediation effect of resilience on the relationship between childhood trauma and mood disorders, as well as the severity of depressive symptoms in a population-based sample.

METHODS

This is a cross-sectional study with a community sample of young adults with bipolar disorder (BD), major depressive disorder (MDD), and community controls without any mood disorder. The trauma experiences during childhood were assessed by Childhood Trauma Questionnaire (CTQ). The severity of depressive symptoms was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS) and to assess the resilience was used the Resilience Scale (RS-25).

RESULTS

All subtypes of trauma were associated with both MDD and BD, however, only physical and emotional abuse differentiated BD from MDD subjects. Bootstrapping-enhanced mediation analyses indicated that resilience partly mediated the association of childhood trauma to both mood disorder and severity of depression.

LIMITATION

The employed mediation analyses are cross-sectional in nature, which limits any firm conclusions regarding causality.

CONCLUSIONS

The findings support the clinical assumption that resilient subjects may be partly protected against the detrimental long-term effects of childhood trauma. This study provides important information regarding the relationships among childhood trauma, resilience, and mood disorder.

摘要

背景

心境障碍领域的研究主要集中在与疾病发生相关的风险因素或与疾病临床进展相关的临床因素上。对于韧性等可能与心境障碍病程中更好结局相关的因素关注较少。在这项研究中,我们评估了韧性在童年创伤与心境障碍之间的关系以及严重程度中的中介作用抑郁症状在基于人群的样本中。

方法

这是一项横断面研究,研究对象为双相情感障碍(BD)、重性抑郁障碍(MDD)和无任何心境障碍的社区对照的年轻成年人的社区样本。童年期创伤经历采用童年期创伤问卷(CTQ)评估。使用蒙哥马利-阿斯伯格抑郁评定量表(MADRS)评估抑郁症状严重程度,使用韧性量表(RS-25)评估韧性。

结果

所有类型的创伤都与 MDD 和 BD 相关,但只有身体和情感虐待能将 BD 与 MDD 患者区分开来。Bootstrapping 增强中介分析表明,韧性部分中介了童年创伤与心境障碍和抑郁严重程度之间的关系。

局限性

所采用的中介分析具有横断面性质,这限制了任何关于因果关系的明确结论。

结论

研究结果支持了这样一种临床假设,即有韧性的患者可能在一定程度上免受童年创伤的不利长期影响。本研究提供了关于童年创伤、韧性和心境障碍之间关系的重要信息。

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