估算和预测童年期性虐待或亲密伴侣暴力所致精神障碍的全球负担:2021年全球疾病负担研究分析
Estimating and forecasting global burden of mental disorders attributable to childhood sexual abuse or intimate partner violence: An analysis for the Global Burden of Disease Study 2021.
作者信息
Xu Ke-Chen, Xie Ying, Chu Fang, Li Meng-Ting, Hao Ze-Qi, Antwi Collins Opoku, Adjei Peter Darko, Li Zi-Yi, Ren Jun
机构信息
School of Psychology, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China.
School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
J Affect Disord. 2025 Jun 18;389:119717. doi: 10.1016/j.jad.2025.119717.
BACKGROUND
As a leading global disease burden, mental disorders require critical assessment of related risk factors through disability-adjusted life years (DALYs) and years lived with disability (YLDs) to understand their public health impact.
METHODS
With the data available from 2021 Global Burden of Disease (GBD), we mainly focused on the effect of childhood sexual abuse (CSA) and intimate partner violence (IPV) on global burden of mental disorders. We estimated numbers and the age-standardized rate (ASR) of DALYs/YLDs by sex, age, socio-demographic index (SDI), and country, and calculated the estimated annual percentage change (EAPC). Moreover, we forecasted the DALYs/YLDs using the autoregressive integrated moving average (ARIMA) model from 2022 to 2050.
FINDINGS
From 1990 to 2021, the ASR of CSA-attributable DALYs/YLDs has declined from 18.25 (95 % uncertainty interval [UI] 9.04-31.13) to 18.08 (95%UI 8.75-30.97) per 100,000 population, while IPV-attributable ASR increased to 33.57 (95%UI 0.11-73.57) during the COVID-19 pandemic. In 2021, the highest DALYs/YLDs rate was observed in the 40-45 age group. Females exhibited a higher number and ASR of DALYs/YLDs attributable to CSA than males, and as the sole victims of IPV, they are projected to experience a decline in both metrics from 2022 to 2050. Low-SDI regions consistently had the highest ASR of DALYs and YLDs. India, China, and the U.S. bear the greatest burden, with the U.S. showing the highest increasing trend (EAPC: 1.54 [95%UI 1.25-1.83]), while China exhibited a decline (EAPC: -1.88 [95%UI -2.14 to -1.61]).
CONCLUSIONS
CSA and IPV are key risk factors for mental disorders. The burden imposed on women often attracted more attention in the past, but we see a rising trend in CSA in men. Certain countries like Singapore are doing well while others are struggling. Cross-country learning is thus put forward as important in managing CSA and IPV and their attendant mental disorders.
背景
作为全球主要的疾病负担,精神障碍需要通过伤残调整生命年(DALYs)和带病生存年数(YLDs)对相关风险因素进行关键评估,以了解其对公众健康的影响。
方法
利用2021年全球疾病负担(GBD)提供的数据,我们主要关注儿童期性虐待(CSA)和亲密伴侣暴力(IPV)对全球精神障碍负担的影响。我们按性别、年龄、社会人口指数(SDI)和国家估算了DALYs/YLDs的数量和年龄标准化率(ASR),并计算了估计的年百分比变化(EAPC)。此外,我们使用自回归积分滑动平均(ARIMA)模型预测了2022年至2050年的DALYs/YLDs。
研究结果
从1990年到2021年,每10万人口中,CSA所致DALYs/YLDs的ASR从18.25(95%不确定区间[UI]9.04 - 31.13)降至18.08(95%UI 8.75 - 30.97),而在新冠疫情期间,IPV所致ASR增至33.57(95%UI 0.11 - 73.57)。2021年,40 - 45岁年龄组的DALYs/YLDs率最高。女性因CSA所致的DALYs/YLDs数量和ASR高于男性,且作为IPV的唯一受害者,预计她们在2022年至2050年这两个指标都会下降。低SDI地区的DALYs和YLDs的ASR一直最高。印度、中国和美国负担最重,美国呈现出最高的上升趋势(EAPC:1.54[95%UI 1.25 - 1.83]),而中国呈下降趋势(EAPC:-1.88[95%UI -2.14至-1.61])。
结论
CSA和IPV是精神障碍的关键风险因素。过去,女性所承受的负担往往更受关注,但我们发现男性中CSA呈上升趋势。像新加坡这样的某些国家做得很好,而其他国家则面临困境。因此,跨国学习对于管理CSA和IPV及其引发的精神障碍具有重要意义。