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尼日利亚福利与司法相关青少年创伤后应激障碍和抑郁症的患病率及其相关因素

Prevalence and correlates of post-traumatic stress disorder and depression among welfare- and justice-involved adolescents in Nigeria.

作者信息

Olorunlambe Wasiu, Adeniyi Sherifat

机构信息

Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.

Department of Economics, University of Ibadan, Ibadan, Nigeria.

出版信息

Eur J Psychotraumatol. 2024;15(1):2434316. doi: 10.1080/20008066.2024.2434316. Epub 2024 Dec 18.

Abstract

Childhood maltreatment (CM) is higher among welfare- and justice-involved youth than in those not involved in these systems, which increases the risk of depression and post-traumatic stress disorder (PTSD). However, the mechanisms underlying the link between CM and these two psychiatric conditions are less well understood among at-risk populations in low- and middle-income countries. This study attempts to fill this gap by examining the prevalence of and risk factors for depression and PTSD among at-risk groups in Nigeria. A cross-sectional research design using multistage sampling was adopted. The sample comprised 205 adolescents: justice-involved [102 (49.8%)] and welfare-involved [103 (50.2%)]. In total, 151 (73.7%) were males, while 54 (26.3%) were females. Multivariate logistic regression analysis and multivariate analysis of variance were applied. The results showed that 66.1% of welfare-involved adolescents and 69.6% of justice-involved adolescents reported PTSD, while 68.9% of welfare-involved adolescents and 75.5% of justice-detained adolescents reported depression. Neglect (OR = 0.253; 95% CI 0.146-0.571;  < .001) and witnessing violence (OR = 0.230; 95% CI 0.114-0.597;  < .004) predicted depression. Emotional abuse (OR = 0.186; 95% CI 0.090-0.80;  < .015), witnessing violence (OR = 0.147; 95% CI 0.014-0.876;  < .043), neglect (OR = 0.187; 95% CI 0.14-0.90;  < .008), and physical abuse (OR = 0.27; 95% CI 0.254-0.937;  < .001) predicted PTSD. Also, PTSD significantly differed based on type of placement ( = 6.08,  < .014, = .029), but depression did not differ based on type of placement ( = 2.46,  > .118, = .012). CM profiles are risk factors in PTSD and depression among at-risk groups. CM screening should be included in mental health services of out-of-home placements to prevent the cycle of mental health problems and reoffending. Trauma-focused and cognitive-behavioural therapies have the potential to alleviate the suffering of traumatized adolescents.

摘要

与福利和司法系统相关的青少年遭受童年虐待(CM)的比例高于未参与这些系统的青少年,这增加了患抑郁症和创伤后应激障碍(PTSD)的风险。然而,在低收入和中等收入国家的高危人群中,CM与这两种精神疾病之间联系的潜在机制尚不太清楚。本研究试图通过调查尼日利亚高危人群中抑郁症和PTSD的患病率及危险因素来填补这一空白。采用了多阶段抽样的横断面研究设计。样本包括205名青少年:涉及司法系统的[102名(49.8%)]和涉及福利系统的[103名(50.2%)]。总共有151名(73.7%)为男性,54名(26.3%)为女性。应用了多变量逻辑回归分析和多变量方差分析。结果显示,66.1%涉及福利系统的青少年和69.6%涉及司法系统的青少年报告患有PTSD,而68.9%涉及福利系统的青少年和75.5%被司法拘留的青少年报告患有抑郁症。忽视(比值比[OR]=0.253;95%置信区间[CI]0.146 - 0.571;P<0.001)和目睹暴力(OR = 0.230;95% CI 0.114 - 0.597;P<0.004)可预测抑郁症。情感虐待(OR = 0.186;95% CI 0.090 - 0.80;P<0.015)、目睹暴力(OR = 0.147;95% CI 0.014 - 0.876;P<0.043)、忽视(OR = 0.187;95% CI 0.14 - 0.90;P< .008)和身体虐待(OR = 0.27;95% CI 0.254 - 0.937;P<0.001)可预测PTSD。此外,PTSD根据安置类型有显著差异(F = 6.08,P<0.014,η² = 0.029),但抑郁症根据安置类型无差异(F = 2.46,P>0.118,η² = 0.012)。CM概况是高危人群中PTSD和抑郁症的危险因素。CM筛查应纳入家庭外安置的心理健康服务中,以防止心理健康问题和再次犯罪的循环。以创伤为重点的认知行为疗法有可能减轻受创伤青少年的痛苦。

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