抑郁症患者与非抑郁症人群中儿童期虐待与社会支持的关系
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首都卫生发展科研专项(首发2020-2-1171);北京市医院管理局“青苗”计划专项经费 资助(QML20181904);北京市属医院科研培育计划项目(PX2020073)


Relationship between childhood abuse and social support in depressed patients and non-depressed people
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    目的 研究抑郁症患者与非抑郁症人群中儿童期虐待与社会支持的关系。方法 本研究 采用非匹配的病例对照研究,对2014 年1 月至2017 年12 月北京安定医院符合入排标准的研究对象进行 研究,共连续纳入224 例抑郁症患者及214 例非抑郁症人群。采用调查问卷(自编)收集研究对象的基本 信息(年龄、性别、婚姻状态、教育水平、工作状态、吸烟史及体质量指数)、疾病史、精神疾病家族史;采 用儿童期虐待问卷中文版(CTQ-SF)评估研究对象16 岁前的经历;采用社会支持评定量表(SSRS)评估 研究对象在过去生活状态中获得的社会支持情况,包含客观支持、主观支持和支持利用3 个维度。采 用单因素分析对抑郁症患者与非抑郁症人群进行基本资料、CTQ-SF及SSRS 评分的比较,采用多因素 Logistic 回归分析影响成年期患者抑郁发生的因素。结果 抑郁症患者中有儿童期虐待经历者(93 例, 41.52%)多于非抑郁症人群(51 例,23.8%),差异有统计学意义(χ2=15.51,P < 0.01)。多因素Logistic 回 归分析显示,儿童期虐待是成年期抑郁的重要危险因素(OR=2.030,95%CI:1.302~3.164)。抑郁症患者 社会支持总分[(32.33±7.45)分]、主观支持[8(6,10)分]、客观支持[17(14,21)分]及支持利用度得分 [6(5,8)分]均低于非抑郁症人群[分别为(36.79±6.24)、9(7, 11)、20(17, 23)、8(6, 9)分],差异均有统 计学意义(均P<0.01)。抑郁症患者中,有儿童期虐待者社会支持得分[(30.41±7.99)分]、主观支持得分 [7(5,9)分]、客观支持得分[(16.57±4.78)分]均低于无儿童期虐待经历者[分别为(33.70±6.76)、9(7,10)、 (18.53±4.35)],差异均有统计学意义(均P < 0.01);非抑郁症人群中,有儿童期虐待者主观支持得分 [8(6,10)分]低于无儿童期虐待经历者[9(7,11)分],差异有统计学意义(P < 0.01)。结论 儿童期虐 待是成年期抑郁症及获得社会支持的重要影响因素。

    Abstract:

    Objective To explore the relationship between childhood abuse and social support in depressed and non-depressed people. Methods In this study, non matched case-control study was used to study the subjects who met the inclusion criteria in Beijing Anding Hospital from January 2014 to December 2017. A total of 224 patients with depression and 214 patients without depression were enrolled. The basic information( age, gender, marital status, education level, work status, smoking history and body mass index), disease history and family history of mental illness were collected by questionnaire( self-made). The Chinese version of the Childhood Trauma Questionnaire( CTQ-SF) was used to evaluate the menstrual status before the age of 16. Social support rating scale( SSRS) was used to evaluate the social support of the subjects in their past life state, including three dimensions: objective support, subjective support and support utilization. Univariate analysis was used to compare the basic data, CTQ-SF and SSRS scores between depression patients and non depression patients. Multivariate logistic regression analysis was used to analyze the factors influencing the occurrence of depression in adult patients. Results The number of depressive patients with childhood abuse( 93 cases, 41.52%) was more than that of non depression patients( 51 cases, 23.8%), the difference was statistically significant( χ2=15.51,P< 0.01). Multivariate logistic regression analysis showed that childhood abuse was an important risk factor for adult depression( OR=2.030, 95%CI:1.302-3.164). The total score of social support (32.33±7.45), subjective support[ 8(6,10)], objective support[ 17(14,21) score] and support utilization score [6(5,8)] of depression patients were lower than those of non depression group[ (36.79±6.24), 9(7,11), 20(17, 23), 8(6,9), respectively], and the differences were statistically significant( P< 0.01). The scores of social support( 30.41±7.99), subjective support[ 7(5,9)], objective support[ (16.57±4.78)] in depression patients with childhood abuse were lower than those without childhood abuse[ (33.70±6.76), 9(7,10),(18.53±4.35)], and the differences were statistically significant( P<0.01). In non depression patients, the score of subjective support of the patients with childhood abuse[ 8(6,10)] was lower than that of the patients without childhood abuse[ 9(7,11)], the difference was statistically significant( P<0.01). Conclusions Childhood abuse is an important risk factor affecting depression and social support in adulthood.

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周佳 肖乐 胡昌清 丰雷.抑郁症患者与非抑郁症人群中儿童期虐待与社会支持的关系[J].神经疾病与精神卫生,2020,20(8):
DOI :10.3969/j. issn.1009-6574.2020.08.005.

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  • 在线发布日期: 2020-12-07