Zhu Siyu, Liu Yuanfei, Ying Jiayao, Jiang Denan, Xiao Wenhan, Zhou Jiali, Shan Shiyi, Zhang Chenhao, Yang Lili, Song Peige
Center for Clinical Big Data and Statistics of the Second Affiliated Hospital Zhejiang University School of Medicine, School of Public Health Zhejiang University School of Medicine, Hangzhou China.
Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Child Abuse Negl. 2025 Mar;161:107254. doi: 10.1016/j.chiabu.2025.107254. Epub 2025 Jan 24.
Nurses demonstrate a greater vulnerability to developing depressive and anxiety symptoms compared to the general population. Adverse Childhood Experiences (ACEs) are known risk factors for mental health issues, but impact of timing of these experiences remains unclear.
To investigate associations between timing of ACEs and depressive, anxiety, comorbid symptoms.
Using convenience sampling, a cross-sectional study was conducted. The sample was 1966 female nurses from seven hospitals in Zhejiang Province, China.
Nurses completed a questionnaire assessing sociodemographic characteristics, ACEs, depressive and anxiety symptoms. Timing of ACEs was categorized as childhood, adolescence, and both periods. Comorbid symptoms referred to simultaneous presence of both depressive and anxiety symptoms. Multivariable logistic regression was used to examine associations between ACEs timing and mental health outcomes, presented as Odds Ratios (ORs) with 95 % Confidence Intervals (CIs).
A total of 429 (21.82 %) participants experienced ACEs in both periods. ACEs occurring only in childhood, only in adolescence, and in both periods were all associated with increased depressive, anxiety, and comorbid symptoms. An increasing trend in number of ACEs from childhood to adolescence was linked to higher symptoms in adulthood. Familial ACEs in both periods were strongly linked to higher depressive (OR = 1.85, 95 % CI [1.14, 3.01]), anxiety (OR = 2.55, 95 % CI [1.41, 4.60]), and comorbid symptoms (OR = 2.92, 95 % CI [1.50, 5.70]).
The timing of ACEs influenced the development of mental health issues. It is imperative to provide targeted psychological support based on timing of ACEs to improve mental health in this population.
与普通人群相比，护士更容易出现抑郁和焦虑症状。童年不良经历（ACEs）是已知的心理健康问题风险因素，但这些经历的发生时间的影响尚不清楚。
研究ACEs发生时间与抑郁、焦虑、共病症状之间的关联。
采用便利抽样法进行横断面研究。样本为来自中国浙江省七家医院的1966名女护士。
护士完成一份问卷，评估社会人口学特征、ACEs、抑郁和焦虑症状。ACEs的发生时间分为童年期、青春期和两个时期。共病症状指抑郁和焦虑症状同时存在。采用多变量逻辑回归分析ACEs发生时间与心理健康结局之间的关联，以优势比（OR）和95%置信区间（CI）表示。
共有429名（21.82%）参与者在两个时期都经历过ACEs。仅在童年期、仅在青春期以及在两个时期都发生的ACEs均与抑郁、焦虑和共病症状增加有关。从童年到青春期ACEs数量的增加趋势与成年期更高的症状有关。两个时期的家庭ACEs与更高的抑郁（OR = 1.85，95% CI [1.14, 3.01]）、焦虑（OR = 2.55，95% CI [1.41, 4.60]）和共病症状（OR = 2.92，95% CI [1.50, 5.70]）密切相关。
ACEs的发生时间影响心理健康问题的发展。必须根据ACEs的发生时间提供有针对性的心理支持，以改善该人群的心理健康。
