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童年早期的不良经历会增加成年多发性硬化症患者患抑郁症的几率。

Adverse childhood experiences in early life increase the odds of depression among adults with multiple sclerosis.

作者信息

Guerrero Karla S, Horton Mary K, Choudhary Vidhu, Bellesis Kalliope H, Dorin Pete, Mei Jin, Chinn Terrence, Meyers Travis J, Schaefer Catherine A, Barcellos Lisa F

机构信息

Division of Epidemiology, School of Public Health, University of California Berkeley, CA, USA.

Kaiser Permanente Division of Research, Oakland, CA, USA.

出版信息

Mult Scler J Exp Transl Clin. 2023 Oct 4;9(4):20552173231202638. doi: 10.1177/20552173231202638. eCollection 2023 Oct-Dec.

Abstract

BACKGROUND

Adverse childhood experiences are demonstrated risk factors for depression, a common co-morbidity of multiple sclerosis, but are understudied among people with multiple sclerosis.

OBJECTIVE

Estimate the association between adverse childhood experiences and depression among 1,990 adults with multiple sclerosis.

METHODS

Participants were members of Kaiser Permanente Northern California from two studies between 2006 and 2021 and were diagnosed with multiple sclerosis by a neurologist. Adverse childhood experiences were assessed using two instruments, including the Behavioral Risk Factor Surveillance System. Participants self-reported ever experiencing a major depressive episode. Meta-analysis random effects models and logistic regression were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between adverse childhood experiences and a history of depression across study samples. Adverse childhood experiences were expressed as any/none, individual events, and counts. Models adjusted for sex, birth year, race, and ethnicity.

RESULTS

Exposure to any adverse childhood experiences increased the odds of depression in people with multiple sclerosis (OR: 1.71, 95% CI: 1.21-2.42). Several individual adverse childhood experiences were also strongly associated with depression, including "significant abuse or neglect" (OR: 2.79, 95% CI: 2.11-3.68).

CONCLUSION

Findings suggest that adverse childhood experiences are associated with depression among people with multiple sclerosis. Screening for depression should be done regularly, especially among people with multiple sclerosis with a history of adverse childhood experiences.

摘要

背景

童年不良经历是抑郁症的已证实风险因素,抑郁症是多发性硬化症常见的共病,但在多发性硬化症患者中对此研究不足。

目的

评估1990名成年多发性硬化症患者童年不良经历与抑郁症之间的关联。

方法

参与者是2006年至2021年间两项研究中北加利福尼亚凯撒医疗集团的成员,由神经科医生诊断为多发性硬化症。使用包括行为危险因素监测系统在内的两种工具评估童年不良经历。参与者自我报告曾经历过重度抑郁发作。采用荟萃分析随机效应模型和逻辑回归来估计优势比(OR)和95%置信区间(CI),以评估跨研究样本中童年不良经历与抑郁症病史之间的关系。童年不良经历表示为有/无、个别事件和计数。模型对性别、出生年份、种族和民族进行了调整。

结果

暴露于任何童年不良经历都会增加多发性硬化症患者患抑郁症的几率(OR:1.71,95%CI:1.21 - 2.42)。一些个别童年不良经历也与抑郁症密切相关,包括“严重虐待或忽视”(OR:2.79,95%CI:2.11 - 3.68)。

结论

研究结果表明,童年不良经历与多发性硬化症患者的抑郁症有关。应定期进行抑郁症筛查,尤其是在有童年不良经历史的多发性硬化症患者中。

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