Ferrara Pietro, Cammisa Ignazio, Zona Margherita, Pacucci Ivana, Grimaldi Maria Teresa, Scaltrito Francesca, Giardino Ida, Verrotti Alberto, Pettoello-Mantovani Massimo
Department of Medicine and Surgery, University Campus Bio-Medico, Roma, Italy.
Operative Research Unit of Pediatrics, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Curr Pediatr Rev. 2024 Jul 25. doi: 10.2174/0115733963316599240704061209.
Child maltreatment is a widespread global issue involving any form of harm or neglect by a parent or caregiver, leading to various forms of physical or emotional damage, with approximately 150 million affected children globally. This study discusses the potential mechanism of the hypothalamic-pituitary-adrenal axis dysfunction and cortisol hormone changes in linking child maltreatment to mental health disorders. It also discusses supportive strategies to prevent mental diseases and counteract the biological embedding of these conditions, emphasizing the need for comprehensive interventions to address the long-term impact of child maltreatment on mental health. Articles were selected using established methods previously described. Key information was obtained from scientific articles published during the past 20 years, including original studies, systematic reviews, and meta-analyses. Articles search was performed using top academic search engines. While research on hypothalamic-pituitary-adrenal axis response to stress in maltreated children is ongoing and far from conclusive, its impact and implications for physiological functioning and the predisposition to psychopathology are significant. Childhood maltreatment increases the risk of psychiatric illnesses, severity of diseases, and poor treatment responses. Childhood maltreatment manifests as disruptions to hypothalamic-pituitary-adrenal axis functioning, with the extent varying based on factors, such as the age of onset, parental responsiveness, and the type and characteristics of maltreatment. The complex interplay of these factors contributes to the diversity of hypothalamic-pituitary-adrenal axis responses to stress in maltreated children, creating a spectrum of physiological functioning and vulnerability to psychopathology.
儿童虐待是一个全球性的普遍问题，涉及父母或照顾者的任何形式的伤害或忽视，会导致各种形式的身体或情感损害，全球约有1.5亿儿童受影响。本研究探讨下丘脑-垂体-肾上腺轴功能障碍和皮质醇激素变化在儿童虐待与精神健康障碍之间的潜在机制。它还讨论了预防精神疾病和对抗这些疾病生物嵌入的支持性策略，强调需要采取综合干预措施来应对儿童虐待对心理健康的长期影响。文章使用先前描述的既定方法进行选择。关键信息来自过去20年发表的科学文章，包括原始研究、系统评价和荟萃分析。文章检索使用顶级学术搜索引擎。虽然关于下丘脑-垂体-肾上腺轴对受虐待儿童应激反应的研究仍在进行且远未得出结论，但其对生理功能和精神病理学易感性的影响及意义重大。童年期虐待会增加精神疾病的风险、疾病的严重程度以及治疗反应不佳的情况。童年期虐待表现为下丘脑-垂体-肾上腺轴功能的破坏，其程度因发病年龄、父母反应性以及虐待的类型和特征等因素而异。这些因素的复杂相互作用导致受虐待儿童下丘脑-垂体-肾上腺轴对应激反应的多样性，形成了一系列生理功能和对精神病理学的易感性。
