Department of Psychiatry, Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9070, USA; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Psychiatry, Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9070, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
Psychiatry Res. 2020 Nov;293:113412. doi: 10.1016/j.psychres.2020.113412. Epub 2020 Aug 18.
This study examined: 1) the prevalence of childhood maltreatment (CMT) in individuals with chronic and/or recurrent depression, 2) the association between CMT and depressive symptoms, 3) the link between CMT and worse clinical presentation of depression, 4) the effects of accumulation of different types of CMT, and 5) the relationship between the age at CMT and depression.
We analyzed the baseline data of 663 individuals from the CO-MED study. CMT was determined by a brief self-reported questionnaire assessing sexual abuse, emotional abuse, physical abuse, and neglect. Correlational analyses were conducted.
Half of the sample (n = 331) reported CMT. Those with CMT had higher rates of panic/phobic, cognitive and anhedonic symptoms than those without CMT. All individual types of maltreatment were associated with a poorer clinical presentation including: 1) earlier MDD onset; 2) more severe MDD, 3) more suiccidality, 4) worse quality of life, and functioning, and 5) more psychiatric comorbidities. Clinical presentation was worse in participants who reported multiple types of CMT.
In chronic and/or recurrent depression, CMT is common, usually of multiple types and is associated with a worse clinical presentation in MDD. The combination of multiple types of CMT is associated with more impairment.
本研究旨在:1)调查患有慢性和/或复发性抑郁症的个体中童年期虐待(CMT)的流行情况;2)CMT 与抑郁症状之间的关联;3)CMT 与抑郁症更严重临床表现之间的联系;4)不同类型 CMT 的累积效应;5)CMT 年龄与抑郁症之间的关系。
我们分析了 CO-MED 研究中 663 名个体的基线数据。CMT 通过一个简短的自我报告问卷评估来确定,该问卷评估了性虐待、情感虐待、身体虐待和忽视。进行了相关分析。
样本的一半(n=331)报告了 CMT。有 CMT 的人比没有 CMT 的人更容易出现惊恐/恐惧症、认知和快感缺失症状。所有类型的虐待都与更差的临床表现相关,包括:1)更早期的 MDD 发作;2)更严重的 MDD;3)更高的自杀风险;4)更差的生活质量和功能;5)更多的精神共病。报告多种类型 CMT 的参与者的临床表现更差。
在慢性和/或复发性抑郁症中,CMT 很常见,通常是多种类型的,与 MDD 的更差临床表现相关。多种类型 CMT 的组合与更多的损害相关。