本文選題：嚴重精神障礙 + 童年期　； 參考：《寧夏醫(yī)科大學》2017年碩士論文

【摘要】：目的:分析童年期家庭不良經歷與成人期精神障礙的相關性,為進一步探討精神障礙的發(fā)病機制,開展早期干預提供參考。方法:采用病例對照研究設計,分別以2016年7月至9月期間,在寧夏三家精神專科醫(yī)院住院治療的嚴重精神障礙患者,和寧夏地區(qū)精神障礙流行病學調查中診斷的常見精神障礙患者為病例組;以寧夏地區(qū)未滿足任一精神障礙的社區(qū)居民為對照組。病例組和對照組根據年齡、性別行頻數(shù)匹配,三組各272例,共816例患者納入最后分析。病例組的診斷采用ICD-10診斷標準,全部精神檢查均采用臨床定式精神檢查完成。童年期家庭不良經歷采用童年期不良經歷清單(Childhood Adversed Experience Checklist,CAEC)收集相關信息,包括:家庭結構不全、軀體虐待、父母之間家庭暴力、忽視、父母犯罪坐牢、父母精神異常、父母物質濫用等七個方面內容。Logistic回歸模型分析童年期家庭不良經歷與重性精神障礙的相關性。結果:1.嚴重精神障礙患者主要以精神分裂癥患者為主,占87.87%;平均年齡在嚴重精神障礙組、對照組和常見精神障礙組分別為36.0±10.9歲、36.7±11.1歲、36.5±1.8歲;三組在回、漢族構成上(χ2=139.63,p0.001)、文化程度構成(χ2=68.85,p0.001)上差異有顯著性。2.嚴重精神障礙組在家庭結構不全的比例(21.5%)、童年期遭受虐待的比例(21.7%)、遭受家庭暴力的比例(26.1%)、被忽視的比例(27.6%)、父母犯罪坐牢的比例(3.1%)、父母精神異常的比例(24.0%)、父母物質濫用史陽性比例(21.0%)均高于對照組(P0.05))。多因素分析結果:采用非條件Logistic逐步回歸法模型篩選變量,控制了性別、年齡、民族等一般人口學變量后,最終進入回歸方程的變量包括:虐待(OR=3.06,95%CI:2.29-4.10)、忽視(OR=28.55,95%CI:10.14-80.39)、家庭暴力(OR=3.60,95%CI:2.58-5.02)、家庭結構不全(OR=11.65,95%CI:5.12-26.53)、父母物質使用障礙(OR=15.17,95%CI:5.33-43.21)、父母精神異常(OR=2.28,95%CI:1.37-3.80)、任一不良經歷(OR=6.01,95%CI:3.70-9.78)、兩項不良經歷(OR=22.34,95%CI:11.69-42.71)。3.常見精神障礙組家庭結構不全的比例(13.2%)顯著高于對照組(P0.05))。采用非條件Logistic逐步回歸模型控制了性別、年齡、民族等一般人口學變量后,最終進入回歸方程的變量有家庭結構不全(OR=5.97,95%CI:2.43-14.64)。結論:各項童年期家庭不良經歷均與成人期嚴重精神障礙存在顯著統(tǒng)計學差異;童年期家庭結構不全與成人期常見精神障礙存在顯著的統(tǒng)計學關聯(lián);童年期家庭不良經歷可能對成人期嚴重精神障礙的患病風險影響更為明顯。
[Abstract]:Objective: to analyze the correlation between childhood family bad experience and adult mental disorder, and to provide reference for further exploring the pathogenesis of mental disorder and carrying out early intervention. Methods: a case-control study was used to study the patients with severe mental disorders who were hospitalized in three psychiatric hospitals in Ningxia from July to September 2016. The patients with common mental disorders diagnosed in the epidemiological survey of mental disorders in Ningxia region were selected as case group, and the community residents who did not satisfy any mental disorders in Ningxia area were taken as the control group. The patient group and control group were matched according to age and sex. 272 cases in each group were included in the final analysis. ICD-10 criteria were used in the diagnosis of the patients, and all psychiatric examinations were completed by clinical routine psychiatric examination. Family Bad experiences in Childhood Adversed Experience ChecklistCAECs are used to collect relevant information, including: incomplete family structure, physical abuse, domestic violence between parents, neglect, parents in prison for crimes, mental disorders of parents. Logistic regression model was used to analyze the correlation between family bad experiences and mental disorders in childhood. The result is 1: 1. The average age of the patients with severe mental disorders was 36.0 鹵10.9 years old, 36.7 鹵11.1 years old and 36.5 鹵1.8 years old, respectively, and the mean age of the three groups was 36.0 鹵10.9 years old or 36.5 鹵1.8 years old, and the mean age was 36.0 鹵10.9 years old or 36.7 鹵11.1 years old or 36.5 鹵1.8 years old respectively. There was significant difference in the composition of Han nationality (蠂 ~ (2)) (蠂 ~ (2)) (139.63) and the educational level (蠂 ~ (2) = 68.85) (P 0.001). There was a significant difference in the composition of Han nationality (蠂 ~ (2)). The proportion of severe mental disorders in the family structure is 21.50.The proportion of maltreatment in childhood is 21.7and that of domestic violence is 26.1%. The proportion of neglected mental disorders is 27.60.The proportion of parents who commit crimes in prison is 3.1%, the proportion of parents with mental disorders is 24.0%, the proportion of parents with material materials is lower than that of parents. The positive rate of abusing history (21.0%) was higher than that of control group (P 0.05). Results of multivariate analysis: the variables were screened by non-conditional Logistic stepwise regression model, and the general demographic variables such as sex, age and nationality were controlled. 鏈，

本文編號：1783313