童年创伤对青少年抑郁症患者非自杀性自伤行为的影响

Childhood trauma experiences and their impact on non-suicidal self-injury in adolescents with first episode depressive disorder

目的:探讨童年创伤对青少年首次发病抑郁症患者非自杀性自伤行为(non-suicidal self-injury,NSSI)的影响。方法:纳入60例青少年抑郁症患者,并根据DSM-5评估有无NSSI,将患者分为伴NSSI组(n=24)和不伴NSSI组(n=36)。所有入组对象采用儿童期创伤问卷(Childhood Trauma Questionnaire,CTQ-SF)评估童年虐待和忽视经历,抑郁自评量表(Self-Rating Depression Scale,SDS)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)、症状自评量表(Symptom Checklist-90,SCL-90)评估抑郁、焦虑及其他心理症状,并进行组间比较。采用二元Logistic回归分析探究童年创伤对NSSI的独立风险。采用Pearson相关分析分析NSSI与童年创伤的关系。结果:60例患者中24例(40.0%)存在NSSI行为,40例(66.7%)经历过童年创伤。与不伴NSSI组相比,伴NSSI组在情绪虐待[(10.3±3.8)分与(15.3±5.5)分,t=4.15,P<0.01]、情绪忽视方面[(13.5±5.4)分与(17.0±5.2)分,t=2.51,P=0.02]差异有统计学意义。Logistic回归分析显示情绪虐待是NSSI的独立风险因素(OR=1.22,95%CI 1.0%~1.5%,P=0.015)。Pearson相关分析显示伴NSSI的患者童年创伤与抑郁、焦虑等心理症状的严重程度呈正相关。结论:青少年抑郁症患者中NSSI的检出率较高,可能与其早期的童年创伤有关。

Objective This study aims to investigate experience and their impact on non-suicidal self-injury(NSSI)in adolescents with first episode depressive disorder.Methods A sample of 60 patients were divided into two groups(with(n=24)and without(n=36)NSSI).Childhood trauma experiences were assessed with the Childhood Trauma Questionnaire(CTQ-SF).The severity of depression,anxiety,and other mental health-related symptoms was assessed with the Self-Rating Depression Scale(SDS),the Self-Rating Anxiety Scale(SAS),and the Symptom Checklist-90(SCL-90).Binary Logistic regression analysis was used to explore the independent risk of childhood trauma to NSSI.Pearson correlation analysis was used to analyze the relationship between NSSI and childhood trauma.Results The prevalence of NSSI in depressed adolescents was 40.0%(n=24),and 66.7%(n=40)of the patients reported that they had experienced childhood trauma.Compared with patients without NSSI,patients with NSSI had significantly higher scores of emotional abuse(10.3±3.8 vs.15.3±5.5,t=4.15,P<0.01)and emotional neglect(13.5±5.4 vs.17.0±5.2,t=2.51,P=0.02).Logistic regression analysis showed that emotional abuse was an independent risk factor of NSSI(OR=1.22,95%CI 1.0%-1.5%,P=0.015).Pearson correlation analysis showed that childhood trauma in patients with NSSI was positively correlated with the severity of psychological symptoms(e.g.,depression and anxiety).Conclusion Childhood trauma experiences are reported frequently by depressed adolescents and may be considered as a potential risk of NSSI.