儿童期受虐经历与抑郁的元分析

本研究采用元分析技术探讨儿童期虐待亚类型与抑郁的关系。通过文献搜索与检查获得了31项研究和92个独立效应量,共包含24283名被试。元分析表明儿童期虐待亚类型(心理虐待与忽视、性虐待、身体虐待与忽视)对抑郁障碍存在不同程度的影响,其中心理虐待与忽视影响程度最高;另外,被试的年龄、性别可以调节儿童期虐待与抑郁的关系。这些结果表明了在预防和治疗儿童期不良经历对抑郁影响时,尤其要关注心理虐待与忽视的消极影响,且应给予青少年群体、女性更多的关注和保护。

Childhood maltreatment and depression: A Meta-Analysis

Childhood maltreatment is closely correlated with depression but only a few studies have examined the specific effects of various types of childhood abuse on depression.Moreover,the comparability of previous research is seriously limited because a high level of heterogeneity can be observed across the published studies.This meta-analysis was to estimate the association between depression and different types of childhood maltreatment (psychological abuse and neglect,sexual abuse,physical abuse and neglect).A systematic review was conducted to study the relationship between subtype of childhood maltreatment and depression.A total of 92 independent effect sizes (31 studies,24283 participants) were found within the criteria of the meta-analysis.After coding the data,independent effect sizes were analyzed by CMA 3.0 program.Odd ratios and 95 ％ CI of effect sizes were calculated by using random-effects model.Four items including heterogeneity test,publication bias test,main effects analysis and moderation effect were analyzed.There was a significant heterogeneity in 92 independent effect sizes in heterogeneity,and the random-effects model was an appropriate model for subsequent meta-analyses.The impact of publication bias was modest and the major finding still remained valid.The research revealed a robust association between childhood maltreatment and depression (OR =2.84,95％ CI:2.45-3.29).In addition,the meta-analyses for each type of maltreatment revealed that psychological abuse (OR =3.58,95％CI 2.87-4.48) and emotional neglect (OR =3.24,95％CI 2.43-4.32) were most strongly associated with the outcome of depression.The analysis revealed that the participant's age and sex could affect the relationship between childhood maltreatment and depression.This meta-analysis addressed the different effects of sub-types for childhood maltreatment on depression.The findings implied that childhood maltreatment was a genuine risk factor for depression,especially highlighting the potential impact of the more "silent" types of childhood maltreatment on the development of depression.Moreover,our findings raise our awareness for the potential needs of adolescents or women who were formerly exposed to childhood abuse.This is important to prevent their depression and is thus a general public health issue.Clinicians also have to be aware of the importance of early childhood experiences to better meet the needs of their patients.