童年期虐待经历与青春期抑郁症状的前瞻性关联

Prospective association between childhood abuse experiences and depressive symptoms in adolescence

目的探讨童年期虐待经历与青春期抑郁症状的前瞻性关联。方法于2013年5月方便选取安徽省蚌埠市3所小学，根据知情同意原则，对参加研究的3-4年级学生进行身高、体重测量，同时开展问卷调查，其中学生问卷包括童年期受虐待经历（情感、躯体和性虐待）和抑郁症状等；父母问卷包括父母学历和家庭经济条件等信息。2017年3月进行随访。基线抑郁症状采用儿童抑郁量表评价，随访期抑郁症状采用《心境与情绪问卷》评价。建立多因素二分类非条件logistics回归模型，分析童年期虐待经历与青春期抑郁症状的前瞻性关联。结果2013年基线调查l172名学生，4年后随访l021名（87．1％）。基线童年期虐待经历报告完整的学生为1126名，其中躯体、情感和性虐待报告率分别为12．8％（144／1126）、11．1％（125／1126）和10．9％（123／1126）。基线与随访期抑郁症状报告率分别为7．0％（82／1172）和12．3％（126／1021）。logistic回归结果表明，调整基线抑郁症状、随访时年龄、性别、独生子女、家庭经济状况、父母离婚、BMl分类后，童年期情感虐待经历（OR=1．86，95％CI：1．03。3．36；P=0．039）和躯体虐待经历（OR=2．37，95％CI：1．39-4．03；P=0．001）增加青春期抑郁症状发生风险。结论童年期情感虐待和躯体虐待可能增加青春期抑郁症状发生的风险。

Objective To evaluate the prospective association between childhood abuse experiences and depressive symptoms in adolescence. Methods Students in grade 3 and 4 from three primary schools were selected, with informed consent, through convenience cluster sampling in Bengbu, Anhui province in May 2013. The students＇ body height, weight were assessed. Childhood abuse experiences including emotional, physical or sexual abuses, as well as depressive symptoms were reported by children themselves. Data on parental educational background and household economic status were collected through parent questionnaire. A follow up was conducted 4 years later after baseline survey. Depressive symptoms were evaluated by using Children＇ s Depression Inventory at baseline survey, and by using Mood and Feeling Questionnaire at follow-up. Logistic regression model was used to analyze the relationship between childhood abuse experiences and depressive symptoms in adolescence. Results A total of 1 172 students were included in baseline survey, and a follow-up was conducted for 87.1% of them （n=1021）. Among 1 126 students with complete information on childhood abuse experiences at baseline survey, the reported rates of physical, emotional and sexual abuses were 12.8% （144/1 126）, 11.1% （125/1 126） and 10.9% （123/1 126）, respectively. The prevalence of depressive symptoms at baseline survey and follow-up was 7.0% （82/1 172） and 12.3% （126/1 021）, respectively. After adjusted for baseline depressive symptoms, age at follow-up, sex, the only-child in family, household economic status, divorce of parents and BMI, childhood emotional and physical abuse experiences were significant risk factors for depressive symptoms in mid-adolescence, with the ORs were 1.86 （95%CI： 1.03-3.36, P=0.039） and 2.37 （95%CI： 1.39-4.03, P=0.001）, respectively. Conclusion Childhood physical and emotional abuse might increase the risk of depressive svmntoms in adolescence.