童年期精神疾病及虐待史与青少年生活质量的关系研究  

Relationship of Childhood Abuse and Psychiatric Disorders with Adolescent Quality of Life in China

作　　者：肖博[1] 孟甜甜[1] 何玉琼[1] 罗学荣[1] XIAO Bo;MENG Tiantian;HE Yuqiong;LUO Xuerong(Mental Health Institute,the Second Xiangya Hospital of Central South University/China National Clinical Research Center for Mental Health Disorders/National Technology Institute of Psychiatry/Key Laboratory of Psychiatry and Mental Health of Hunan Province,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院精神卫生研究所,国家精神心理疾病临床研究中心,精神疾病诊疗技术工程实验室,湖南省精神病学与精神卫生重点实验室,湖南省长沙市410011

出　　处：《中国全科医学》2018年第29期3616-3621,共6页Chinese General Practice

基　　金：“十二五”国家科技支撑计划项目(2012BAI01B02)。

摘　　要：背景寿命的延长已无法满足现代人对健康的追求,人们开始关注生活质量,青少年成长中会受很多因素的影响,但对儿童生活质量的影响却没有明确的数据支持。目的探讨童年期发生各类精神疾病及遭受虐待经历对青少年生活质量的影响及其相关因素。方法本研究数据来自课题组2014年2—7月大型流行病学调查数据,研究对象来自湖南省长沙市和益阳市,采用二阶段调查方法:第一阶段采用Achenbach儿童行为(CBCL)量表初筛,按1∶2筛选出828例患有精神疾病的儿童作为病例组,性别、年龄与其匹配的1 656例健康儿童作为对照组,采用简明儿童少年国际神经精神访谈(MINIKid)进行精神障碍的临床诊断,采用儿童期虐待问卷(CTQ-SF)及SF-12量表对儿童进行虐待史及生活质量的评估。结果病例组中患有1种精神疾病的患儿有508例(61.4%),患有2种精神疾病的患儿有195例(23.5%),患有3种及以上精神疾病的患儿有125例(15.1%)。对照组与病例组儿童居住地、是否为独生子女、母亲文化程度、家庭经济情况、是否为留守儿童,CTQ-SF情感虐待、躯体虐待、性虐待、心理忽视评分,SF-12量表生理功能(PF)、生理职能(RP)、社会功能(SF)、情感职能(RE)、总体健康(GH)、躯体疼痛(BP)、活力(VT)评分、生理总评分(PCS)和心理总评分(MCS)比较,差异均有统计学意义(P<0.05)。有虐待史组PCS和MCS低于无虐待史组(P<0.05)。无虐待史组、1种虐待亚组、2种及以上虐待亚组PCS和MCS比较,差异有统计学意义(P<0.05);其中2种及以上虐待亚组PCS和MCS低于无虐待史组及1种虐待亚组(P<0.05)。病例组女性患儿RP、SF评分高于男性(P<0.05);病例组无共病患儿VT评分高于有共病患儿(P<0.05);病例组无虐待史患儿PCS和MCS高于有虐待史患儿(P<0.05)。多元线性回归分析结果显示:性别、年龄、父亲文化程度、精神疾病、虐待史是PCS的影响因素(F总=54.164,P<Background Nowadays,people's pursuit of health is not only reflected in prolonging life,but also embodied in improving the quality of life.Although many factors associated with adolescent growth have been studied extensively,currently there is little research available on whether quality of life in childhood can affect it.Objective To explore the impact and associated factors of childhood abuse and psychiatric disorders on adolescent quality of life in China.Methods The data in this study were from a large epidemiological survey carried out from February to July 2014 by us.The participants were selected from 16 schools in Changsha and Yiyang,Hunan Province and grouped by using two-stage sampling:first,according to the results of CBCL questionnaire survey and clinical evaluation,3 094 students(924 with psychiatric disorders and 2 170 healthy controls)were included.Then,using a computer-based C#language programming,we assigned the psychiatric disorders cases to the case group(828 cases)and healthy controls(1 656 sex-and age-matched cases)to the control group according to the ratio of 1∶2.We used Mini International Neuropsychiatric Interview for Children and Adolescents(MINIKid)to diagnose psychiatric disorders cases in detail.Childhood Trauma Questionnaire Short Form(CTQ-SF)and SF-12 were used to evaluate the history of abuse and the quality of life of both groups.Results Of the case group,508(61.4%)were identified with 1 type of psychiatric disorder,195(23.5%)with two types of psychiatric disorders,and other 125(15.1%)with three or more types of psychiatric disorders.The residence,prevalence of the only child,maternal educational attainment,family economic status,prevalence of left-behind child,scores of 4 subscales of CTQ-SF(emotional abuse,physical abuse,sexual abuse and emotional neglect),scores of 7 dimensions(PF,RP,SF,RE,GH,BP,VT),and scores of 2 subscales〔physical component summary(PCS)and mental component summary(MCS)〕of SF-12 differed significantly between the groups(P<0.05).Participants with a histo

关 键 词：虐待儿童 精神疾病 生活质量 

分 类 号：R179[医药卫生—妇幼卫生保健]