Stangeland Helle, Aakvaag Helene Flood, Baumann-Larsen Monica, Wentzel-Larsen Tore, Ottesen Akiah, Zwart John Anker, Storheim Kjersti, Dyb Grete, Stensland Synne Øien
Section for Trauma, Disasters and Forced Migration - Children and Youth, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway; and Institute of Clinical Medicine, University of Oslo, Norway.
Section for Violence and Trauma, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
Br J Psychiatry. 2024 Nov;225(5):476-483. doi: 10.1192/bjp.2024.98.
Better knowledge about childhood trauma as a risk factor for psychiatric disorders in young people could help strengthen the timeliness and effectiveness of prevention and treatment efforts.
To estimate the prevalence and risk of psychiatric disorders in young people following exposure to childhood trauma, including interpersonal violence.
This prospective cohort study followed 8199 adolescents (age range 12-20 years) over 13-15 years, into young adulthood (age range 25-35 years). Data about childhood trauma exposure from adolescents participating in the Trøndelag Health Study (HUNT, 2006-2008) were linked to data about subsequent development of psychiatric disorders from the Norwegian Patient Registry (2008-2021).
One in four (24.3%) adolescents were diagnosed with a psychiatric disorder by young adulthood. Regression analyses showed consistent and significant relationships between childhood exposure to both interpersonal violence and other potentially traumatic events, and subsequent psychiatric disorders and psychiatric comorbidity. The highest estimates were observed for childhood exposure to two or more types of interpersonal violence (polyvictimisation), and development of psychotic disorders (odds ratio 3.41, 95% CI 1.93-5.72), stress and adjustment disorders (odds ratio 4.20, 95% CI 3.05-5.71), personality disorders (odds ratio 3.98, 95% CI 2.70-5.76), alcohol-related disorders (odds ratio 3.28, 95% CI 2.06-5.04) and drug-related disorders (odds ratio 4.67, 95% CI 2.87-7.33).
These findings emphasise the importance of integrating knowledge about childhood trauma as a potent risk factor for psychopathology into the planning and implementation of services for children, adolescents and young adults.
更深入了解童年创伤作为年轻人精神疾病的风险因素，有助于提高预防和治疗工作的及时性和有效性。
评估年轻人在经历童年创伤（包括人际暴力）后精神疾病的患病率和风险。
这项前瞻性队列研究对8199名青少年（年龄在12至20岁之间）进行了13至15年的跟踪，直至青年期（年龄在25至35岁之间）。参与特隆赫姆健康研究（HUNT，2006 - 2008年）的青少年关于童年创伤暴露的数据，与挪威患者登记处（2008 - 2021年）中关于随后精神疾病发展的数据相联系。
四分之一（24.3%）的青少年在青年期被诊断患有精神疾病。回归分析表明，童年时期经历人际暴力和其他潜在创伤事件与随后的精神疾病及精神疾病共病之间存在一致且显著的关系。童年暴露于两种或更多类型人际暴力（多重受害）以及发展为精神分裂症（比值比3.41，95%置信区间1.93 - 5.72）、应激和适应障碍（比值比4.20，95%置信区间3.05 - 5.71）、人格障碍（比值比3.98，95%置信区间2.70 - 5.76）、酒精相关障碍（比值比3.28，95%置信区间2.06 - 5.04）和药物相关障碍（比值比4.67，95%置信区间2.87 - 7.33）时，观察到的估计值最高。
这些发现强调了将童年创伤作为精神病理学的一个重要风险因素的知识，纳入儿童、青少年和青年服务的规划和实施中的重要性。
