Levitan R D, Parikh S V, Lesage A D, Hegadoren K M, Adams M, Kennedy S H, Goering P N
Centre for Addiction and Mental Health and the Department of Psychiatry, University of Toronto, Ont, Canada.
Am J Psychiatry. 1998 Dec;155(12):1746-52. doi: 10.1176/ajp.155.12.1746.
Numerous studies have linked childhood trauma with depressive symptoms over the life span. However, it is not known whether particular neurovegetative symptom clusters or affective disorders are more closely linked with early abuse than are others. In a large community sample from Ontario, the authors examined whether a history of physical or sexual abuse in childhood was associated with particular neurovegetative symptom clusters of depression, with mania, or with both.
The World Health Organization Composite International Diagnostic Interview was used to assess 8,116 individuals aged 15-64 years. Each subject was asked about early physical and sexual abuse experiences on a structured supplement to the interview. Six hundred fifty-three cases of major depression were identified. Rates of physical and sexual abuse in depressive subgroups defined by typical and reversed neurovegetative symptom clusters (i.e., decreased appetite, weight loss, and insomnia versus increased appetite, weight gain, and hypersomnia, respectively) and by the presence or absence of lifetime mania were compared by gender.
A history of physical or sexual abuse in childhood was associated with major depression with reversed neurovegetative features, whether or not manic subjects were included in the analysis. A strong relationship between mania and childhood physical abuse was found. Across analyses there was a significant main effect of female gender on risk of early sexual abuse; however, none of the group-by-gender interactions predicted early abuse.
These results suggest an association between early traumatic experiences and particular symptom clusters of depression, mania, or both in adults.
众多研究已将童年创伤与一生的抑郁症状联系起来。然而，尚不清楚特定的神经植物性症状群或情感障碍是否比其他症状与早期虐待的联系更为紧密。在安大略省的一个大型社区样本中，作者研究了童年期身体虐待或性虐待史是否与抑郁症的特定神经植物性症状群、躁狂症或两者都有关联。
使用世界卫生组织综合国际诊断访谈来评估8116名年龄在15至64岁之间的个体。在访谈的结构化补充内容中，询问了每位受试者早期的身体和性虐待经历。确定了653例重度抑郁症病例。比较了按典型和反向神经植物性症状群（即分别为食欲减退、体重减轻和失眠与食欲增加、体重增加和睡眠过多）以及是否有终生躁狂定义的抑郁亚组中的身体和性虐待发生率，并按性别进行了比较。
无论分析中是否纳入躁狂症患者，童年期身体虐待或性虐待史都与具有反向神经植物性特征的重度抑郁症有关。发现躁狂症与童年期身体虐待之间存在密切关系。在各项分析中，女性性别对早期性虐待风险有显著的主效应；然而，按性别分组的交互作用均未预测早期虐待情况。
这些结果表明，早期创伤经历与成年人抑郁症、躁狂症或两者的特定症状群之间存在关联。
