Wang Wei-Li, Hung Hao-Yuan, Chung Chi-Hsiang, Hsu Ju-Wei, Huang Kai-Lin, Chan Yuan-Yu, Chien Wu-Chien, Chen Mu-Hong
Department of Psychiatry, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Section 2, Taipei 11217, Taiwan; Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
Department of Pharmacology, National Defense Medical Center, Taipei, Taiwan; Department of Pharmacy Practice, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; National Defense Medical Center, Graduate Institute of Medical Sciences, Taipei, Taiwan.
J Affect Disord. 2022 May 15;305:28-36. doi: 10.1016/j.jad.2021.12.109. Epub 2021 Dec 26.
To date, numerous cohort studies and meta-analyses have shown that childhood maltreatment is associated with a wide range of adverse physiological and psychological symptoms. Although childhood maltreatment has been linked to an increased risk of personality disorders, the direction and magnitude of the association remain uncertain. Therefore, this cohort study aimed to evaluate whether children who have suffered childhood maltreatment have a higher incidence of subsequent personality disorders, using a nationwide database in Taiwan.
We conducted a large retrospective cohort study using data drawn from Taiwan's National Health Insurance Research Database between 2000 and 2015. A total of 10,345 children who experienced childhood maltreatment were identified using International Classification of Disease codes. They were then compared with 41,380 children who never experienced childhood maltreatment in terms of the prevalence rates of personality disorders.
Childhood maltreatment was associated with an increased risk of personality disorders (considering the control as reference: adjusted hazard ratio, 2.12; 95% confidence interval, 1.90-2.36; p < 0.001). The Kaplan-Meier analysis revealed a significantly higher 15-year cumulative incidence of personality disorders among childhood maltreatment victims than among controls (log-rank test, p < 0.001).
The present population-based study showed a positive association between prior childhood maltreatment and subsequent personality disorders in the general Taiwanese population. In order to reduce the risk of personality disorders, interventions should be implemented, identifying and supporting economically disadvantaged families and vulnerable children as early as possible.
迄今为止，众多队列研究和荟萃分析表明，童年期受虐与广泛的不良生理和心理症状相关。尽管童年期受虐与人格障碍风险增加有关，但这种关联的方向和程度仍不确定。因此，本队列研究旨在利用台湾的一个全国性数据库，评估遭受童年期受虐的儿童随后患人格障碍的发生率是否更高。
我们进行了一项大型回顾性队列研究，使用的数据来自2000年至2015年台湾国民健康保险研究数据库。通过国际疾病分类编码确定了总共10345名经历过童年期受虐的儿童。然后将他们与41380名从未经历过童年期受虐的儿童在人格障碍患病率方面进行比较。
童年期受虐与人格障碍风险增加有关（以对照组为参照：调整后的风险比为2.12；95%置信区间为1.90 - 2.36；p < 0.001）。Kaplan-Meier分析显示，童年期受虐受害者的人格障碍15年累积发病率显著高于对照组（对数秩检验，p < 0.001）。
本基于人群的研究表明，台湾普通人群中童年期受虐史与随后的人格障碍之间存在正相关。为了降低人格障碍的风险，应实施干预措施，尽早识别并支持经济弱势家庭和易受伤害的儿童。
