童年创伤对抑郁症患者躯体化症状的影响

周若尘; 叶孟婷; 余凤琼; 周晓琴

doi:10.16766/j.cnki.issn.1674-4152.003494

童年创伤对抑郁症患者躯体化症状的影响

doi: 10.16766/j.cnki.issn.1674-4152.003494

1.
安徽医科大学精神卫生与心理科学学院，安徽合肥 230000
2.
安徽医科大学附属巢湖医院精神科，安徽巢湖 238000
3.
安徽医科大学第二附属医院心理与睡眠医学科，安徽合肥 230000

基金项目:

国家自然科学基金项目 32371134

详细信息

通讯作者:
周晓琴，E-mail：zhouxqlulu@126.com

中图分类号: R749.4
计量
- 文章访问数: 44
- HTML全文浏览量: 21
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2023-11-16
- 网络出版日期: 2024-07-20

The effect of childhood trauma on somatization symptoms in depressed patients

1.
School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui 230000, China

摘要

摘要: 目的观察不同类型抑郁症患者在童年创伤上的差异, 并探索童年创伤是否会对抑郁症患者的躯体化症状产生影响。方法选择2022年10月-2023年12月在安徽医科大学附属巢湖医院精神科及安徽医科大学第二附属医院精神科就诊的抑郁症患者共121人, 评估CTQ-SF童年创伤量表简版、SCL90症状自评清单的躯体化子量表及17项汉密尔顿抑郁量表。结果有躯体化症状的抑郁症患者的CTQ-SF总分高于不伴有躯体化症状的抑郁症患者[46.50(39.25, 58.25)vs.39.50(34.00, 50.00), Z=-2.662, P < 0.01];有躯体化症状的抑郁症患者有更高的躯体忽视[8.00(7.00, 10.00)vs.7.00(5.00, 9.00), Z=-2.683, P < 0.01]及情感虐待[9.50(7.00, 15.00)vs.8.00(6.00, 11.50), Z=-2.317, P < 0.05]得分。童年创伤的严重程度与抑郁症患者躯体化症状的严重程度呈正相关关系(P < 0.01), 控制抑郁症状严重程度后这种关联依然存在(P < 0.01);躯体化症状与除性虐待外的童年创伤均相关联(P < 0.01);在控制抑郁症状严重程度之后, 躯体化症状仍与躯体忽视(P < 0.01)及情感虐待(P < 0.05)呈正相关关系。结论有躯体化症状的抑郁症患者经历了更严重的童年创伤, 包括躯体忽视与情感虐待在内的童年创伤史对抑郁症患者的躯体化症状有影响。
- 抑郁症 /
- 童年创伤 /
- 躯体化
Abstract: Objective To observe the effects of childhood trauma on patients with different types of depression, and explore whether childhood trauma affects the somatic symptoms of depressed patients. Methods A total of 121 depressed patients who attended outpatient clinics and were hospitalized in the psychiatry department of Chaohu Hospital Affiliated with Anhui Medical University and the Psychiatry Department of the Second Affiliated Hospital of Anhui Medical University from October 2022 to December 2023 were selected to assess the short version of the childhood trauma questionnaire short form (CTQ-SF) childhood trauma inventory, the somatization subscale of the SCL90 symptom self-assessment checklist, and the 17-item Hamilton depression inventory. Results Depressed patients with somatization symptoms had higher CTQ-SF total scores than depressed patients without somatization symptoms[46.50(39.25, 58.25)vs.39.50(34.00, 50.00), Z=-2.662, P < 0.01];depressed patients with somatization symptoms had higher levels of somatic neglect[8.00(7.00, 10.00)vs.7.00(5.00, 9.00), Z=-2.683, P < 0.01]and emotional abuse[9.50(7.00, 15.00)vs.8.00(6.00, 11.50), Z=-2.317, P < 0.05]scores.The severity of childhood trauma was positively associated with the severity of somatization symptoms in depressed patients (P < 0.01), and this association persisted after controlling for the severity of depressive symptoms (P < 0.01);somatization symptoms were associated with all childhood traumas except sexual abuse (P < 0.01);and after controlling for the severity of depressive symptoms, somatization symptoms remained associated with somatic neglect (P < 0.01) and emotional abuse (P < 0.05) were positively associated. Conclusion Depressed patients with somatization symptoms experienced more severe childhood trauma, and a history of childhood trauma, including physical neglect and emotional abuse, had an impact on somatization symptoms in depressed patients.
- Depression /
- Childhood trauma /
- Somatization

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表 1 无躯体化症状组与躯体化症状组一般人口学及汉密尔顿抑郁量表评分比较

Table 1. Comparison of demographic data and Hamilton depression rating scale scores between non-somatization and somatization groups

项目	类别	总数(n=121)	无躯体化症状组(n=45)	有躯体化症状组(n=76)	统计量	P值
性别[例(%)]	男性	42(34.71)	20(44.44)	22(28.95)	2.995^a	0.084
	女性	79(65.29)	25(55.56)	54(71.05)
年龄[M(P₂₅, P₇₅)，岁]		23.00(20.00，30.00)	25.00(20.00，31.00)	23.00(19.00，30.00)	-0.527^b	0.598
受教育程度[例(%)]	小学	3(2.48)	0	3(3.95)
	初中或高中	25(20.66)	10(22.22)	15(19.74)	1.869^a	0.393
	大学或以上	93(76.86)	35(77.78)	58(76.32)
婚姻状况[例(%)]	已婚	34(28.10)	15(33.33)	19(25.00)
	未婚	86(71.07)	30(66.67)	56(73.68)	1.486^a	0.476
	离婚	1(0.83)	0	1(1.32)
就业情况[例(%)]	就业	54(44.63)	20(44.44)	34(44.74)
	失业	17(14.05)	8(17.78)	9(11.84)	0.927^a	0.629
	学生	50(41.32)	17(37.78)	33(43.42)
发病年龄[M(P₂₅, P₇₅)，岁]		22.00(18.00，29.00)	25.00(18.50，29.50)	22.00(18.00，28.00)	-0.858^b	0.391
吸烟[例(%)]	是	12(9.92)	3(6.67)	9(11.84)
	否	109(90.08)	42(93.33)	67(88.16)	0.000^a	1.000
喝酒[例(%)]	是	4(3.31)	1(2.22)	3(3.95)
	否	117(96.69)	44(97.78)	73(96.05)	0.570^a	0.450
汉密尔顿抑郁量表评分(x±s)		18.81±5.67	16.20±5.97	20.30±4.90	-4.099^c	< 0.001
注：^a为χ²值，^b为Z值，^c为t值。

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表 2 伴有躯体化症状组与不伴有躯体化症状组童年创伤量表得分比较[M(P₂₅, P₇₅)，分]

Table 2. Comparison of childhood trauma scale scores between groups with and without somatization symptoms [M(P₂₅, P₇₅), points]

项目	总数(n=121)	无躯体化症状组(n=45)	有躯体化症状组(n=76)	Z值	P值
童年创伤总分	44.00(36.00，52.00)	39.50(34.00，50.00)	46.50(39.25，58.25)	-2.662	0.008
躯体忽视总分	8.00(6.00，10.00)	7.00(5.00，9.00)	8.00(7.00，10.00)	-2.683	0.007
情感忽视总分	15.00(10.00，17.50)	13.00(8.00，17.00)	15.00(11.25，18.00)	-1.459	0.144
躯体虐待总分	5.00(5.00，7.00)	5.00(5.00，6.50)	6.00(5.00，8.00)	-1.788	0.074
情感虐待总分	9.00(6.00，13.00)	8.00(6.00，11.50)	9.50(7.00，15.00)	-2.317	0.020
性虐待总分	5.00(5.00，6.00)	5.00(5.00，5.00)	5.00(5.00-6.00)	-0.794	0.427

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表 3 抑郁症患者的躯体化症状与童年创伤之间的相关性分析

Table 3. Analysis of the correlation between somatization symptoms in depression patients and childhood trauma

项目	躯体化症状	童年创伤总分	躯体忽视	情感忽视	躯体虐待	情感虐待	性虐待
躯体化症状	1.000
童年创伤总分	0.390^a	1.000
躯体忽视	0.356^a	0.743^a	1.000
情感忽视	0.235^a	0.834^a	0.643^a	1.000
躯体虐待	0.250^a	0.602^a	0.280^a	0.331^a	1.000
情感虐待	0.358^a	0.828^a	0.485^a	0.521^a	0.549^a	1.000
性虐待	0.121	0.272^a	0.177	0.035	0.119	0.193^a	1.000
注：^aP < 0.05。

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表 4 控制抑郁严重程度后抑郁症患者的躯体化症状与童年创伤之间的相关性分析

Table 4. Analysis of the correlation between somatization symptoms and childhood trauma in depressive patients after controlling for depression severity

项目	躯体化症状	童年创伤总分	躯体忽视	情感忽视	躯体虐待	情感虐待	性虐待
躯体化症状	1.000
童年创伤总分	0.274^a	1.000
躯体忽视	0.328^a	0.748^a	1.000
情感忽视	0.146	0.802^a	0.576^a	1.000
躯体虐待	0.087	0.654^a	0.300^a	0.327^a	1.000
情感虐待	0.240^a	0.809^a	0.455^a	0.472^a	0.604^a	1.000
性虐待	0.153	0.292^a	0.176	0.039	0.059	0.100	1.000
注：^aP < 0.05。

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