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一项利用链接的全州儿童保护和行政健康数据对 1983 年至 2014 年 83050 名昆士兰州居民进行的儿童虐待与精神障碍的纵向出生队列研究。

A longitudinal birth cohort study of child maltreatment and mental disorders using linked statewide child protection and administrative health data for 83,050 Queensland residents from 1983 to 2014.

机构信息

Griffith Criminology Institute, Griffith University, Brisbane, Australia.

Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Saint Lucia, Australia.

出版信息

Epidemiol Psychiatr Sci. 2024 Nov 20;33:e69. doi: 10.1017/S204579602400074X.

Abstract

AIMS

Most information about the association between childhood maltreatment (CM) and subsequent psychiatric morbidity is based on retrospective self-reports. Findings from longitudinal studies using prospective reports to statutory agencies may be subject to attrition. We therefore compared the prevalence to age 30 of inpatient psychiatric diagnoses in those who experienced agency-reported CM with those of the rest of the cohort using administrative data to minimise loss to follow-up.

METHODS

We used linked administrative data for two birth cohorts of all individuals born in Queensland, Australia in 1983 and 1984 ( = 83,050) and followed to age 30 years. This was the entire cohort aside from 312 people who died. Information on CM came from statewide child protection data and psychiatric diagnoses from all public and private hospital admissions in Queensland.

RESULTS

On adjusted analyses, the 4,703 participants (5.7%) who had been notified to the statewide child protection authority had three to eight times the odds of being admitted for any of the following psychiatric diagnoses by age 30 years old: schizophrenia-spectrum disorders, bipolar affective disorders, depression, anxiety and post-traumatic stress disorders (PTSD). There were similar findings for all the CM subtypes. Associations were especially strong for PTSD with between a seven - and nine-fold increase in the odds of admission.

CONCLUSIONS

This is one of the largest studies of the long-term effects of CM, covering an entire jurisdiction. All types of maltreatment are significantly related to a range of psychiatric disorders requiring hospitalisation. Early identification, intervention and providing appropriate support to individuals who have experienced CM may help mitigate the long-term consequences and reduce the risk of subsequent mental health problems.

摘要

目的

大多数关于儿童期虐待(CM)与随后精神疾病发病之间关联的信息都是基于回顾性自我报告。使用向法定机构进行前瞻性报告的纵向研究的结果可能会受到流失的影响。因此,我们使用行政数据将经历机构报告的 CM 的患者与队列中的其余患者进行比较,以最小化随访流失,比较他们在 30 岁时住院精神科诊断的患病率。

方法

我们使用昆士兰州 1983 年和 1984 年(= 83,050)出生的所有个体的两个出生队列的链接行政数据,并随访至 30 岁。这是除了 312 名死亡者之外的整个队列。CM 信息来自全州范围内的儿童保护数据,精神科诊断来自昆士兰州所有公立和私立医院的住院治疗。

结果

在调整后的分析中,4703 名(5.7%)被全州儿童保护局通知的参与者,在 30 岁之前因以下任何一种精神科诊断入院的可能性是其他参与者的三到八倍:精神分裂症谱系障碍、双相情感障碍、抑郁症、焦虑症和创伤后应激障碍(PTSD)。所有 CM 亚型都有类似的发现。PTSD 的关联尤其强烈,入院的几率增加了七到九倍。

结论

这是关于 CM 长期影响的最大研究之一,涵盖了整个司法管辖区。所有类型的虐待都与一系列需要住院治疗的精神疾病显著相关。早期识别、干预并为经历过 CM 的个体提供适当的支持,可能有助于减轻长期后果并降低随后出现心理健康问题的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c2b/11669797/300f3599822e/S204579602400074X_fig1.jpg

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