Department of Neurology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China.
Department of Project Design and Statistics, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China.
J Affect Disord. 2022 Feb 1;298(Pt A):104-109. doi: 10.1016/j.jad.2021.10.093. Epub 2021 Oct 29.
Lack of parental raising is an important reason for parental loss in China due to urbanization. We aimed to explore the association between parental loss (including parental death, divorce, alcoholism, crime, drug addiction, bedridden, and lack of parental raising) before 17 years old and mental health disorders in adulthood in Southwest China.
Childhood parental loss, age, gender, socioeconomic status, smoking, drinking, and medical history were self-reported. Patient Health Questionnaire 9 (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) were used for identifying depression and anxiety, respectively. We use logistic regression with inverse probability weighting according to the propensity score to assess the risk of childhood parental loss on mental health disorders in adulthood.
A total of 8014 adults were enrolled in this study. Childhood parental loss increased the risk of adulthood depression (OR, 1.60, 95%CI, 1.30-1.98) but not anxiety (p= 0.07) after adjustment of all covariates. Sensitivity analyses including logistic regression with original data, nearest neighbor matching, full matching, and propensity score as the only covariate all yielded similar results.
Recall bias could not be fully eliminated due to the retrospective nature of study design. Our study had been conducted in a less-prosperous area in Southwest China and the results may not be representative at nation level.
Childhood parental loss was associated with depression in adulthood in Southwest China, highlighting the need for early intervention in children with parental loss, to prevent long-term negative effects on their mental health.
由于城市化，在中国父母缺失的一个重要原因是缺乏父母抚养。我们旨在探讨 17 岁以前的父母缺失（包括父母死亡、离婚、酗酒、犯罪、吸毒、卧床不起和缺乏父母抚养）与中国西南地区成年人心理健康障碍之间的关系。
童年期父母缺失、年龄、性别、社会经济地位、吸烟、饮酒和病史均为自我报告。使用患者健康问卷 9（PHQ-9）和广泛性焦虑症 7 项量表（GAD-7）分别识别抑郁和焦虑。我们使用逆概率加权的逻辑回归根据倾向评分来评估童年期父母缺失对成年期心理健康障碍的风险。
本研究共纳入 8014 名成年人。在调整所有协变量后，童年期父母缺失增加了成年期抑郁的风险（OR，1.60，95%CI，1.30-1.98），但对焦虑没有影响（p=0.07）。包括原始数据的逻辑回归、最近邻匹配、完全匹配和倾向评分作为唯一协变量的敏感性分析均得出了相似的结果。
由于研究设计的回顾性，无法完全消除回忆偏倚。我们的研究是在中国西南地区一个欠发达的地区进行的，结果可能不具有全国代表性。
童年期父母缺失与中国西南地区成年人的抑郁有关，这突显了对父母缺失的儿童进行早期干预的必要性，以防止其心理健康受到长期负面影响。
