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成年精神疾病患者中有童年创伤史者的复发和住院时间延长的流行情况及相关因素。

Prevalence and factors associated with relapse and long hospital stay among adult psychiatric patients with a history of childhood trauma.

机构信息

Department of Psychiatry, Kampala International University Western Campus Bushenyi, Uganda; Department of Internal Medicine, Masereka General Referral Hospital, North-Kivu, Democratic Republic of the Congo.

Department of psychiatry, University of Kinshasa, Democratic Republic of Congo.

出版信息

Psychiatry Res. 2022 Oct;316:114745. doi: 10.1016/j.psychres.2022.114745. Epub 2022 Jul 26.

Abstract

This cross-sectional multicentre-based study determined the magnitude of relapse, long hospital stay and factors of mental illness associated with a history of childhood trauma. We assessed 335 adult psychiatric patients and living in conflict areas, using a questionnaire established from items of the Adverse Childhood Experience International Questionnaire, Multidimensional Scale of Perceived Social Support, Rosenberg Self-esteem Questionnaire, Relapse Assessment Tool, and Self-report of hospital stay. Logistic regression analyses were used to determine associations between predictors and relapse and long hospital stay. 298 participants (88.9%) had experienced childhood adversities, among which 44.4% reported more than five childhood traumas. Relapse occurred in 40.9% of participants, whereas long hospital stay occurred in 71.1% of cases. Predictors of long hospital stay were emotional abuse, substance use and living in rural settings. Being an employed and experiencing a childhood trauma committed by a parent increase the likelihood risk of relapse of mental illness associated with childhood trauma. Being treated by childhood trauma-focused interventions decreases the risk of relapse and shorter the length of hospital stay. Building a mental health capacity should be centered on detecting patients with childhood trauma committed by the parent, those with low-self esteem, and victims of emotional abuse.

摘要

本横断面多中心研究旨在确定与儿童期创伤史相关的复发、住院时间延长和精神疾病因素的严重程度。我们评估了 335 名生活在冲突地区的成年精神科患者,使用了一个从儿童期创伤国际问卷、多维感知社会支持量表、罗森伯格自尊量表、复发评估工具和住院时间自我报告的项目中建立的问卷。使用逻辑回归分析来确定预测因子与复发和住院时间延长之间的关联。298 名参与者(88.9%)经历过儿童期逆境,其中 44.4%报告了超过五种儿童创伤。40.9%的参与者出现复发,71.1%的病例住院时间延长。住院时间延长的预测因素是情感虐待、物质使用和生活在农村地区。受雇和经历父母实施的儿童期创伤会增加与儿童期创伤相关的精神疾病复发的风险。接受儿童期创伤为重点的干预措施治疗会降低复发的风险并缩短住院时间。建立心理健康能力应侧重于发现遭受父母实施的儿童期创伤、自尊心低和遭受情感虐待的患者。

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