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儿童期创伤及其对成年期抑郁和焦虑症状的影响:一项 6 年纵向研究。

Childhood trauma and its impact on depressive and anxiety symptomatology in adulthood: A 6-year longitudinal study.

机构信息

Amsterdam UMC location Vrije University Amsterdam, Department of Psychiatry, Amsterdam Public Health (Mental Health program) and Amsterdam Neuroscience (Mood, Anxiety, Psychosis, Stress & Sleep program) research institutes, Amsterdam, the Netherlands.

Amsterdam UMC location Vrije University Amsterdam, Department of Psychiatry, Amsterdam Public Health (Mental Health program) and Amsterdam Neuroscience (Mood, Anxiety, Psychosis, Stress & Sleep program) research institutes, Amsterdam, the Netherlands; Amsterdam UMC location Vrije University Amsterdam, Department of Anatomy and Neurosciences, Amsterdam, the Netherlands.

出版信息

J Affect Disord. 2022 Sep 1;312:322-330. doi: 10.1016/j.jad.2022.06.057. Epub 2022 Jun 24.

Abstract

BACKGROUND

Childhood trauma (CT) is a risk factor for depressive and anxiety disorders. However, whether CT is more strongly linked to specific clinical features of these disorders remains inconclusive. The current study comprehensively examined cross-sectional and longitudinal associations between CT and depressive/anxiety symptomatology in a large adult sample with current and remitted depressive and/or anxiety disorders.

METHODS

Baseline (n = 1803), 2-year (n = 1735), 4-year (n = 1585), and 6-year follow-up (n = 1475) data from the Netherlands Study of Depression and Anxiety were used. CT (emotional neglect, emotional/physical/sexual abuse) was assessed at baseline, while depressive/anxiety symptomatology with relevant dimensions (e.g., mood/cognitive, melancholic, general distress, and somatic depression) was assessed at each wave using self-reported questionnaires. Linear regressions and linear mixed models determined cross-sectional and longitudinal associations.

RESULTS

Individuals with CT, especially, severe CT, compared to those without CT, had significantly higher scores in overall depressive symptomatology (Cohen's d = 0.674), mood/cognitive depression (d = 0.691), melancholic depression (d = 0.587), general distress (d = 0.561), and somatic depression severity (d = 0.549). Differences were lower, but still highly significant for anxiety (d = 0.418), worry (d = 0.362), and fear/phobic symptomatology (d = 0.359). Effects were consistent across CT types and maintained over six years.

LIMITATIONS

Retrospectively-reported CT.

CONCLUSIONS

CT is a risk factor for depressive and anxiety symptomatology across all dimensions and enduring over multiple years. Screening for CT is essential to identify individuals at risk for more severe and chronic manifestations of affective disorders.

摘要

背景

童年创伤(CT)是抑郁和焦虑障碍的风险因素。然而,CT 是否与这些障碍的特定临床特征更紧密相关仍不清楚。本研究在一个有当前和缓解的抑郁和/或焦虑障碍的大型成人样本中,全面检查了 CT 与抑郁/焦虑症状之间的横断面和纵向关联。

方法

使用荷兰抑郁和焦虑研究的基线(n=1803)、2 年(n=1735)、4 年(n=1585)和 6 年随访(n=1475)数据。CT(情感忽视、情感/身体/性虐待)在基线时进行评估,而抑郁/焦虑症状则在每个波次使用自我报告问卷评估相关维度(例如,情绪/认知、忧郁、一般困扰和躯体抑郁)。线性回归和线性混合模型确定了横断面和纵向关联。

结果

与没有 CT 的个体相比,有 CT(尤其是严重 CT)的个体在总体抑郁症状(Cohen's d=0.674)、情绪/认知抑郁(d=0.691)、忧郁性抑郁(d=0.587)、一般困扰(d=0.561)和躯体抑郁严重程度(d=0.549)方面的得分明显更高。对于焦虑(d=0.418)、担忧(d=0.362)和恐惧/恐惧症症状(d=0.359),差异较低,但仍具有高度显著性。这些效应在各种 CT 类型中是一致的,并持续了六年。

局限性

回顾性报告的 CT。

结论

CT 是抑郁和焦虑症状的一个风险因素,涉及所有维度,并持续多年。对 CT 的筛查对于识别有更严重和慢性情感障碍表现风险的个体至关重要。

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