Lancet Public Health:人生早期的创伤相关入院经历与日后自我伤害和人际暴力发生风险的研究

2017-07-26 fengxiangxin MedSci原创

更好地了解那些在童年时经历了心理创伤个体的后续经历可能有助于临床医生和公共卫生专业人员了解自我伤害和人际暴力的原因。研究者的目的是评估这类人群(童年有因伤害或中毒而入院的个体)在他们青少年和成年早期自我伤害和人际暴力的风险。

更好地了解那些在童年时经历了心理创伤个体的后续经历可能有助于临床医生和公共卫生专业人员了解自我伤害和人际暴力的原因。研究者的目的是评估这类人群(童年有因伤害或中毒而入院的个体)在他们青少年和成年早期自我伤害和人际暴力的风险。

这个全国性的队列研究包括在197711日至19971231日之间出生的丹麦人。通过与丹麦国家病人注册系统记和精神研究中心注册系统相连接以找出所有15岁以前因自我伤害、人际暴力或意外事故原因受伤而住院的个体。同时通过连接上述两个系统和国家犯罪登记系统可以查出这些个体在之后的15-35岁之间的自我伤害和暴力侵犯经历,分别作为不良结果时间。研究者评估了性别特异性发生率比(IRRs;相对风险)和累积发生百分比值(绝对风险)。此外,还探讨了父母社会经济地位的混杂影响。

共有1087672名丹麦人纳入本研究。任何与创伤相关的住院率为10%(每1087 672人中有105753人,其中男性有64454 [ 11% ],女性有44299 [ 8% ]),无论男女,原因类别评估中因意外事故是最常见的(男性:59011 [ 11% ];女性:40756 [ 8% ])。类似的,在无论男性和女性中都观察到了自我伤害和暴力犯罪风险的增加,尽管IRRs值在女性中(自我伤害:IRR1.94 [ 95% 置信区间:1.85-2.02 ];暴力犯罪:2.16 [ 1.97-2.36 ])始终大于男性(自我伤害:1.61 [ 1.53-1.69 ];暴力犯罪:1.58 [ 1.53-1.63 ])。父母社会经济地位对观察到的风险增加贡献不大

对于年轻成年男性,有暴力侵犯经历的个体(在童年期因人际暴力创伤而入院)的绝对风险最高(累积发生率:25.0% [ 95% 置信区间: 21.2-28.9 ]);对于年轻成年女性,有反复自我伤害经历的个体(在童年期因自我伤害入院)绝对风险最高(累积发生率:21.4% [ 95% 置信区间:19.8-23.1 ])。

儿童时期因多种原因并且不止一次被送入医院的个体,在其年轻时自我伤害和人际暴力的风险有实质性的增加,尤其在女性中这种风险增加较多。

人生早期的创伤相关入院经历是一个预测青年期和成年早期内在和外在的破坏性行为的有的指标,同时可向该个体的家庭及时提供引导干预的机会。

原始出处:

Webb, R.T., S. Antonsen, M.J. Carr, et al., Self-harm and violent criminality among young people who experienced trauma-related hospital admission during childhood: a Danish national cohort study. Lancet Public Health, 2017. 2(7): p. e314-e322.

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    2018-03-14 howi
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    2018-02-17 shizhenshan
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    2017-07-27 184****9840

    学习了受益匪浅

    0

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    2017-07-26 珍珍superwoman

    学习了

    0

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    2017-07-26 林3301

    看看了解一下

    0

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    2017-07-26 fengxiangxin301

    尽早挽救童年受伤的孩子

    0

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