儿童期虐待对青少年心境障碍患者非自杀性自伤行为的影响  

Impact of childhood maltreatment on non-suicidal self-injury in adolescents with mood disorder

作　　者：王丹 李旸 王威 周佳 Wang Dan;Li Yang;Wang Wei;Zhou Jia(Depressive Disorder Treatment Center&the National Clinical Research Center for Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China)

机构地区：[1]首都医科大学附属北京安定医院抑郁症治疗中心,国家精神心理疾病临床医学研究中心,100088

出　　处：《神经疾病与精神卫生》2022年第2期83-88,共6页Journal of Neuroscience and Mental Health

基　　金：首都卫生发展科研专项项目(首发2020-2-1171);北京市属医院科研培育计划项目(PX2020073)。

摘　　要：目的了解青少年心境障碍患者的非自杀性自伤行为(NSSI)现状并探讨儿童期虐待对NSSI的影响。方法采用自编一般资料问卷、儿童期创伤问卷、青少年非自杀性自伤行为问卷对2020年12月至2021年5月于首都医科大学附属北京安定医院门诊及住院就诊的101例13~19岁青少年心境障碍患者进行横断面调查,根据既往是否存在NSSI行为将患者分为伴NSSI组(n=53)和不伴NSSI组(n=48)并进行组间比较。采用单因素和多因素Logistic回归分析方法分析青少年心境障碍患者儿童期虐待对NSSI的影响。结果青少年心境障碍患者的NSSI所占比例为52.47%(53/101)。与不伴NSSI组相比,伴NSSI组在情感虐待[50.94%(27/53)比20.83%(10/48)]、躯体虐待[33.96%(18/53)比16.67%(8/48)]、情感忽视[60.38%(32/53)比33.33%(16/48)]方面的发生比例更高,差异均有统计学意义(χ^(2)=9.837、3.942、7.387,P<0.05);两组患者年龄、性别、受教育程度、是否独生子女、体重指数、是否连续病程、是否首发、是否存在家族史、父母是否离异、疾病诊断比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示,在校正了年龄、性别、诊断后,情感虐待与青少年心境障碍患者NSSI显著相关(OR=3.794,95%CI:1.510~9.532,P<0.05)。结论青少年心境障碍患者发生NSSI行为可能与早期情感虐待经历相关,应针对此群体制订针对性的治疗策略以改善预后。Objective To investigate the current situation of non-suicidal self-injury(NSSI)in adolescents with mood disorder,and to explore the influence of childhood maltreatment on NSSI.Methods A cross-sectional survey was conducted among 101 adolescent patients with mood disorders aged from 13 to 19 years who were treated in the outpatient and inpatient department of Beijing Anding Hospital from December 2020 to May 2021,using the self-made general information questionnaire,Childhood Trauma Questionnaire(CTQ)and NSSI questionnaire to evaluate the childhood maltreatment experiences and NSSI.According the history of NSSI,the patients were divided into two groups:the NSSI group(n=53)and the non-NSSI group(n=48).Univariate analysis and multivariate logistic regression analysis were used to analyze the impact of childhood maltreatment on NSSI in adolescents with mood disorder.Results The proportion of NSSI in adolescents with mood disorders was 52.47%(53/101).Compared with the non-NSSI group,the incidence of emotional abuse[50.94%(27/53)vs 20.83%(10/48)],physical abuse[33.96%(18/53)vs 16.67%(8/48)]and emotional neglect[60.38%(32/53)vs 33.33%(16/48)]was higher in the NSSI group,and the differences were statistically significant(χ^(2)=9.837、3.942、7.387,P<0.05).There were no significant differences in age,gender,education level,only child or not,body mass index(BMI),whether or not continuous course of disease,whether or not first-episode,family history of psychiatric disorders,whether or not parents divorced,and disease diagnosis of patients in two groups(P>0.05).Multivariate logistic regression analysis showed that after adjusting for age,gender,and diagnosis,emotional abuse was significantly associated with NSSI in adolescents with mood disorders(OR=3.794,95%CI:1.510-9.532,P<0.05).Conclusions The early experience of emotional abuse may be related to NSSI in adolescents with mood disorders,and targeted treatment strategies should be developed for this group to improve the prognosis.

关 键 词：心境障碍 非自杀性自伤 儿童期虐待 青少年 

分 类 号：R749.94[医药卫生—神经病学与精神病学]