精神障碍患者儿童期创伤经历状况及影响因素分析

Analysis of childhood traumatic experience and its influencing factors in patients with mental disorders

目的研究精神障碍患者的童年创伤经历,从性别、年龄及有无留守经历等方面综合比较和分析可能的影响因素,为精神障碍患者的治疗提供参考依据。方法在芜湖市第四人民医院,采用整群抽样的方法,由病区医生协助研究者组织患者,采用统一的指导语,运用儿童期创伤问卷对病区患者进行测评。结果女性精神障碍患者总分和情感忽视评分,显著高于男性患者;≤29岁患者躯体虐待因子评分显著高于30~40岁患者;≥41岁患者情感忽视因子评分显著低于≤29岁和30~40岁患者;儿童时期留守的精神障碍患者在情感虐待、躯体虐待、性虐待和情感忽视上评分显著高于儿童时期未留守的患者;心境障碍患者在总分、情感虐待、躯体虐待、性虐待、情感忽视和躯体忽视所有因子评分,均显著高于精神分裂症患者,差异有统计学意义(P<0.05)。结论精神障碍患者早期可能经历了更多的创伤性生活事件,而且这种创伤经历与性别、年龄、是否留守有一定的相关性。

Objective To study the status of childhood traumatic experiences in patients with mental disorders,this paper comprehensively compares and analyzes possible factors from the aspects of sex,household register,family structure,whether the only child and whether or not there are left behind experiences,and provides reference for the treatment of mental disorders. Methods In the Fourth People＇s Hospital of Wuhu,a cluster sampling method was adopted. The patients in the ward were organized by the ward doctors,and the patients were evaluated by using the unified guidance language and the childhood trauma questionnaire for confirmatory factor analysis. Results Total scores of female patients with mental disorders and emotional neglect score significantly higher than male patients; less than 29 year old patient physical abuse factor score was significantly higher than that of 30 ~ 40 years old patients; The scores of mental disorder patients who left behind in childhood were significantly higher than those of children who were not left behind in their emotional abuse,physical abuse,sexual abuse and emotional neglect.More than 41 years old patients with emotional neglect factor scores were significantly lower than those under 29 years old and 30 ~ 40 years old patients; All factors scores of mood disorders in total score,emotional abuse,physical abuse,sexual abuse,emotional neglect and somatic neglect were significantly higher than those in schizophrenics,the difference was statistically significant（ P〈0.05）. Conclusions Patients with mental disorders may experience more traumatic life events at early stage,and this trauma experience is related to gender,age and whether they are left behind.