儿童期创伤与双相情感障碍青少年的自伤行为。
Childhood Trauma and Self-harm in Youths with Bipolar Disorders.
机构信息
Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy.
出版信息
Curr Neuropharmacol. 2024;22(1):152-158. doi: 10.2174/1570159X21666230213155249.
BACKGROUND
Bipolar disorders (BD) in youth are associated with a high risk of self-harm behaviors. Childhood trauma (CT) is a relevant environmental stressor that is related to both BD diagnosis and self-harm in adulthood. It is not yet established whether CT may impact self-harm risk in youth. Therefore, the aim of this study was to investigate the distribution patterns of CT in youth BD with and without self-harm.
METHODS
We assessed 273 participants (aged 13-25 years), 96 youths with BD according to DSM-5 criteria and 177 healthy controls (HC). History of CT was obtained using the Childhood Trauma Questionnaire (CTQ). The association between CT and self-harm was tested using multivariate statistical models.
RESULTS
Over 45% of participants with BD reported lifetime self-harm. The BD Self-harm group reported more emotional abuse, emotional neglect, sexual abuse, and physical abuse than HC. The BD No-Self-harm group reported more emotional abuse than HC. The BD Self-harm group reported more emotional abuse and neglect than the BD No-Self-harm group. The BD Self-harm group also reported separated parents, hospitalizations, smoking, use of antiepileptics, antipsychotics and lithium. Emotional abuse was an independent predictor of self-harm in youths with BD.
CONCLUSION
Findings support the importance of assessing CT, in particular emotional abuse, in youth with BD at risk for self-harm.
背景
青少年双相情感障碍（BD）与自伤行为的风险较高有关。童年创伤（CT）是一种相关的环境应激源，与 BD 诊断和成年后的自伤有关。目前尚不清楚 CT 是否会影响青少年的自伤风险。因此，本研究旨在调查有和无自伤的青少年 BD 中 CT 的分布模式。
方法
我们评估了 273 名参与者（年龄 13-25 岁），96 名符合 DSM-5 标准的青少年 BD 和 177 名健康对照者（HC）。使用童年创伤问卷（CTQ）评估 CT 病史。使用多变量统计模型测试 CT 与自伤之间的关联。
结果
超过 45%的 BD 患者报告有终生自伤。BD 自伤组比 HC 组报告更多的情感虐待、情感忽视、性虐待和身体虐待。BD 无自伤组比 HC 组报告更多的情感虐待。BD 自伤组比 BD 无自伤组报告更多的情感虐待和忽视。BD 自伤组还报告了父母离异、住院、吸烟、使用抗癫痫药、抗精神病药和锂。情感虐待是 BD 青少年自伤的独立预测因素。
结论
研究结果支持在有自伤风险的青少年 BD 中评估 CT（特别是情感虐待）的重要性。
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