童年创伤和家庭功能对青少年心境障碍患者自伤行为的影响

Effect of Childhood Trauma and Family Function on Self-Injury in Adolescents with Mood Disorder

目的:探讨童年创伤和家庭功能对心境障碍患者非自杀性自伤行为影响的具体机制。方法:入组心境障碍患者176例,其中伴自伤92例(伴自伤组),无自伤84例(无自伤组),记录所有入组患者临床基本信息和量表的评估。对2组间的临床基本信息及童年创伤、抑郁体验、家庭功能量表的评分进行比较。结果:伴自伤组在情感虐待(Z=3.330,P=0.001)、躯体虐待(Z=2.400,P=0.017)、情感忽视(Z=3.160,P=0.002)、情感依赖(Z=3.080,P=0.002)和自我批评维度(Z=3.410,P=0.001)得分均显著高于无自伤组。伴自伤组极端型家庭的比例显著高于无自伤组,在平衡型家庭的比例上显著低于无自伤组(χ^(2)=3.400,P=0.046)。多因素Logistic回归分析显示,情感虐待(OR=1.113,95%CI 1.005~1.233)与青少年心境障碍患者自伤行为发生呈正相关(P<0.05)。结论:对比无自伤的心境障碍患者,伴自伤心境障碍患者抑郁体验更深;情感虐待可能是青少年心境障碍患者自伤行为的高风险因素;良好的家庭功能可能有助于减少童年创伤对青少年自伤行为的影响。

Objective:To explore specific mechanism of the influence of childhood trauma and family function on non-suicidal self-injury(NSSI)in mood disorders.Methods:A total of 176 patients with mood disorders were enrolled,including 92 patients with NSSI and 84 patients without NSSI.The basic clinical information and scale assessment of all patients were recorded.The basic clinical information,childhood trauma,depression experience,and family function scale scores were compared between the two groups.Results:The scores of emotional abuse(Z=3.330,P=0.001),physical abuse(Z=2.400,P=0.017),emotional neglect(Z=3.160,P=0.002),dependency(Z=3.080,P=0.002),and self-criticism(Z=3.410,P=0.001)in the group with NSSI were significantly higher than those in the group without NSSI.The ratio of extreme-type family function was significantly higher in the group with NSSI compared to the group without NSSI(χ^(2)=3.400,P=0.046).Multivariate logistic regression analysis showed that emotional abuse(OR=1.113,95%CI=1.005~1.233)was significantly associated with NSSI in adolescents with mood disorders(P<0.05).Conclusion:Mood disorder patients with NSSI may have a deeper experience of depression.Emotional abuse may be a risk factor for NSSI in adolescents with mood disorders.Good family function may help to reduce the influence of childhood trauma on NSSI in adolescents.