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童年期虐待、躯体化与成年期健康相关生命质量的关联:一项基于人群的队列研究结果。

The association of childhood maltreatment, somatization and health-related quality of life in adult age: Results from a population-based cohort study.

机构信息

Institute of Social Medicine and Health Systems Research, Medical Faculty Magdeburg, Magdeburg, Germany.

Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany.

出版信息

Child Abuse Negl. 2021 Oct;120:105226. doi: 10.1016/j.chiabu.2021.105226. Epub 2021 Aug 2.

Abstract

BACKGROUND

Population-based data regarding the relationship between childhood maltreatment (CM), somatization and health-related quality of life (HRQoL) in adults are limited.

OBJECTIVE

To investigate the association of CM history (emotional and physical abuse and neglect, sexual abuse) with somatization and with physical and mental HRQoL in adults.

PARTICIPANTS AND SETTING

Data from 2305 participants from the population-based Study of Health in Pomerania were analyzed (aged 20 to 80 years).

METHODS

We applied the Childhood Trauma Questionnaire. Somatoform disorders were diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) in a clinical interview. Using a self-administered questionnaire, we assessed the number of somatic symptoms and physical and mental HRQoL.

RESULTS

Sexual abuse was related to the diagnosis of a somatoform disorder (odds ratio [OR] 1.87; 95% confidence interval [CI] 1.29, 2.69). Emotional abuse and physical neglect were associated with the number of somatic symptoms (B = 0.93; 95% CI 0.42, 1.45 and B = 0.50; 95% CI 0.17, 1.83, respectively). Sexual abuse and physical neglect were related to lower physical HRQoL (B = -1.87; 95% CI -3.17, -0.57 and B = -1.26; 95% CI -2.02, -0.49, respectively), and emotional abuse was associated with lower mental HRQoL (B = -2.83; 95% CI -4.03, -1.62).

CONCLUSIONS

A history of CM, in particular sexual abuse, emotional abuse and physical neglect, is a risk factor for somatization and impaired HRQoL in adults. Individuals with somatic symptoms are an important target group for CM screening. Addressing HRQoL might be significant in psychotherapy for individuals with CM experience.

摘要

背景

关于儿童虐待(CM)、躯体化和成年人健康相关生活质量(HRQoL)之间关系的基于人群的数据有限。

目的

调查 CM 史(情感和身体虐待以及忽视、性虐待)与躯体化以及与成年人的身体和心理健康相关生活质量的关系。

参与者和设置

对基于人群的波美拉尼亚健康研究的 2305 名参与者的数据进行了分析(年龄在 20 至 80 岁之间)。

方法

我们应用了儿童创伤问卷。根据精神障碍诊断与统计手册,第 4 版(DSM-IV)的标准,在临床访谈中诊断出躯体形式障碍。使用自我管理问卷,我们评估了躯体症状的数量以及身体和心理健康相关生活质量。

结果

性虐待与躯体形式障碍的诊断有关(优势比 [OR] 1.87;95%置信区间 [CI] 1.29,2.69)。情感虐待和身体忽视与躯体症状的数量有关(B=0.93;95%CI 0.42,1.45 和 B=0.50;95%CI 0.17,1.83)。性虐待和身体忽视与较低的身体 HRQoL 有关(B=-1.87;95%CI-3.17,-0.57 和 B=-1.26;95%CI-2.02,-0.49),情感虐待与较低的心理 HRQoL 有关(B=-2.83;95%CI-4.03,-1.62)。

结论

CM 史,特别是性虐待、情感虐待和身体忽视,是成年人躯体化和 HRQoL 受损的危险因素。有躯体症状的个体是 CM 筛查的重要目标人群。在有 CM 经历的个体的心理治疗中,解决 HRQoL 可能很重要。

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