Department of Psychology, Universite de Montreal.
Department of Sexology, Universite du Quebec a Montreal.
Health Psychol. 2021 Feb;40(2):104-112. doi: 10.1037/hea0000994. Epub 2020 Sep 21.
The present study aimed to determine whether psychiatric comorbidity (i.e., diagnostic comorbidity in eight categories of mental and behavioral disorders) mediates the relationship between childhood sexual abuse (CSA) and diseases of the genitourinary system (I, 10th revision) among girls. Using a prospective matched-cohort design, we documented diagnoses given by a physician after a medical consultation or hospitalization for diseases of the genitourinary system, for 661 sexually abused girls and 661 matched controls via administrative databases covering the period between January 1996 and March 2013. Path analyses using negative binomial regressions with CSA as independent variable, psychiatric comorbidity as mediator and genitourinary diseases diagnoses as dependent variables were performed. After controlling for socioeconomic level, prior genitourinary diseases and number of years of medical data, the mediation effect for the path from CSA to genitourinary diseases through psychiatric comorbidity was significant for the urinary system ( = .125, 95% confidence interval [0.057, 0.192]) as well as for the genital system ( = .213, 95% confidence interval [0.141, 0.285]). Psychiatric comorbidity carried 62% of the sexual abuse total effect on the number of diagnoses received for genital diseases, whereas it carried 23% of the sexual abuse total effect on the number of diagnoses received for urinary diseases. Findings suggest that CSA may have an indirect effect on girls' diagnosed genitourinary diseases during a medical consultation or hospitalization through the increased risk for psychiatric comorbidity. Early interventions aimed at addressing psychological distress among sexually abused girls might prevent the emergence of genitourinary diseases years after the abuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
本研究旨在确定精神共病（即 8 类精神和行为障碍的诊断共病）是否在女童中作为童年期性虐待（CSA）与生殖泌尿系统疾病（ICD-10 第 10 版）之间的中介因素。我们采用前瞻性匹配队列设计，通过涵盖 1996 年 1 月至 2013 年 3 月期间的行政数据库，记录了 661 名性虐待女孩和 661 名匹配对照在医疗咨询或因生殖泌尿系统疾病住院后由医生诊断的疾病。我们使用负二项回归路径分析，以 CSA 为自变量，精神共病为中介变量，生殖泌尿系统疾病诊断为因变量。在控制社会经济水平、先前生殖泌尿系统疾病和医疗数据年限后，CSA 通过精神共病对生殖泌尿系统疾病的路径的中介效应在泌尿系统（ =.125，95%置信区间 [0.057，0.192]）和生殖系统（ =.213，95%置信区间 [0.141，0.285]）均具有统计学意义。精神共病携带 CSA 对生殖系统疾病诊断次数的总效应的 62%，而对泌尿系统疾病诊断次数的总效应的 23%。研究结果表明，通过增加精神共病的风险，CSA 可能对女孩在医疗咨询或住院期间被诊断为生殖泌尿系统疾病产生间接影响。早期干预旨在解决遭受性虐待女孩的心理困扰，可能会防止在虐待发生多年后出现生殖泌尿系统疾病。（PsycInfo 数据库记录（c）2021 APA，保留所有权利）。
