儿童期不良经历与青春早期抑郁的关联性

Relationship between adverse childhood experiences and depression in early adolescence

目的探究儿童期不良经历(adverse childhood experiences, ACEs)与青春期早期抑郁之间的关联,为有效应对ACEs对青少年心理健康的影响提供科学依据。方法采取分层整群抽样的方法,于2017年11-12月对上海市3所初中六~八年级全体学生1 629名进行匿名问卷调查,问卷内容包括调查对象基本人口学特征、不同类型ACEs、抑郁情况等。采用χ~2检验和多因素Logistic回归模型分析ACEs与抑郁之间的关联。结果 1 629名学生中,有65.25%有过被忽视经历,其次为虐待(61.26%),家庭功能不良发生率相对较低(20.81%)。79.01%的学生至少经历过1种ACE,61.45%的学生至少经历过2种ACEs,10.01%的学生经历过5种及以上的ACEs。多因素Logistic回归分析显示,学生遭遇过任何一种ACE、虐待、忽视均与抑郁水平相关联(OR=2.62~3.60),仅在男生中发现家庭功能不良与抑郁相关联(OR=1.91),且ACEs评分对抑郁的影响存在累积效应。结论青春期早期青少年不同类型ACEs与抑郁存在关联,且ACEs对抑郁水平有累积效应。

Objective To explore the relationship between Adverse childhood experiences(ACEs) and depression in early adolescence, and to provide scientific basis for effectively coping with the impact of ACEs on adolescents’ mental health. MethodsStratified cluster sampling method was used to select adolescents in grade 6-8 in three middle schools of Shanghai during November and December of 2017. Adolescents were investigated anonymously using computer assisted self-interview approach via the tablets. Information including demographic characteristics, ACEs, and depression was collected. The chi-square test and multivariate logistic regression were used to explore the relationship between ACEs and depression, after controlling potential confounders. Results Totally 1 629 eligible records were obtained. 65.25% of the respondents had experienced of neglect, followed by those abused(61.26%), and the incidence of family dysfunction was relatively low(20.81%). About 79.01% of the respondents had experienced at least one ACE, and more than half(61.45%) of the respondents had experienced at least two ACEs, and 10.01% of the respondents had experienced five or more ACEs. Multivariate logistic regression analysis showed that abuse and neglect experienced by male and female adolescents was associated with depression severity, with the OR values ranging from 2.62 to 3.60. Family dysfunction was found to be associated with depression only in male adolescents, with the OR of 1.91. The cumulative effect of ACE score on depression was observed. Conclusion Different types of ACEs in early adolescents are associated with depression, and ACEs have cumulative effects on depression severity.