重性抑郁障碍患者儿童期虐待与功能失调性态度相关性

Relationship between childhood maltreatment and dysfunctional attitude in patients with major depressive disorder.

目的探索重性抑郁障碍患者儿童期虐待经历与功能失调性态度之间的关系。方法收集173例首发未治疗重性抑郁障碍患者,根据儿童期虐待问卷(childhood trauma questionnaire,CTQ)评分将患者分为受虐待组(102例)与对照组(71例),采用功能失调性态度量表(dysfunctional attitudes scale,DAS)评估认知模式情况,CTQ评估儿童期成长经历,17项汉密尔顿抑郁量表(Hamilton depression scale,HAMD-17)评估抑郁严重程度。结果受虐待组的DAS总分(157.00±35.06 vs.141.30±29.13)及其因子分(除脆弱性及自主性态度外)、CTQ总分[54.00(49.75,62.00)vs.40.00(37.00,43.00)]及其因子分高于对照组(P<0.05)。控制性别、年龄、职业、婚姻状况等因素,多因素线性回归分析显示,患者DAS总分与情感虐待相关联(β=0.331,P<0.001),多项DAS因子分与情感虐待相关联(P<0.05),HAMD-17评分与躯体虐待相关联(β=0.347,P<0.001)。结论儿童期虐待,尤其是情感虐待,可能影响重性抑郁障碍患者成年后的功能失调性态度,躯体虐待与抑郁严重程度紧密相关。

Objective To explore the relationship between childhood maltreatment experience and dysfunctional attitude in patients with major depressive disorder(MDD).Methods One hundred and seventy-three patients with first episode untreated MDD were recruited and divided into the abused group(n=102)and the control group(n=71)according to the Childhood Trauma Questionnaire(CTQ).The potential cognitive dysfunction was assessed with the Dysfunctional Attitudes Scale(DAS).The childhood growth experience was assessed with the CTQ.And the severity of depression was assessed with the Hamilton Depression Scale(HAMD-17).Results The DAS total score of the abused group(157.00±35.06 vs.141.30±29.13)and its factor scores(except frailty and autonomy attitude),CTQ total score[54.00(49.75,62.00)vs.40.00(37.00,43.00)]and its factor scores were significantly higher than those in the control group(P<0.05).Multivariate linear regression showed that DAS total score(β=0.331,P<0.001)and most factor scores were associated with childhood emotional abuse,HAMD-17 score was associated with childhood physical abuse(β=0.347,P<0.001)in MDD patients.Conclusion Childhood maltreatment,especially emotional abuse,can affect adult dysfunctional attitude of patients with MDD,and physical maltreatment is closely related to the severity of depression.