Karla S Guerrero, Mary K Horton, Vidhu Choudhary, Kalliope H Bellesis, Pete Dorin, Jin Mei, Terrence Chinn, Travis J Meyers, Catherine A Schaefer, Lisa F Barcellos
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引用次数: 0
Abstract
Background: Adverse childhood experiences are demonstrated risk factors for depression, a common co-morbidity of multiple sclerosis, but are understudied among people with multiple sclerosis.
Objective: Estimate the association between adverse childhood experiences and depression among 1,990 adults with multiple sclerosis.
Methods: Participants were members of Kaiser Permanente Northern California from two studies between 2006 and 2021 and were diagnosed with multiple sclerosis by a neurologist. Adverse childhood experiences were assessed using two instruments, including the Behavioral Risk Factor Surveillance System. Participants self-reported ever experiencing a major depressive episode. Meta-analysis random effects models and logistic regression were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between adverse childhood experiences and a history of depression across study samples. Adverse childhood experiences were expressed as any/none, individual events, and counts. Models adjusted for sex, birth year, race, and ethnicity.
Results: Exposure to any adverse childhood experiences increased the odds of depression in people with multiple sclerosis (OR: 1.71, 95% CI: 1.21-2.42). Several individual adverse childhood experiences were also strongly associated with depression, including "significant abuse or neglect" (OR: 2.79, 95% CI: 2.11-3.68).
Conclusion: Findings suggest that adverse childhood experiences are associated with depression among people with multiple sclerosis. Screening for depression should be done regularly, especially among people with multiple sclerosis with a history of adverse childhood experiences.
背景:儿童时期的不良经历已被证明是抑郁症的危险因素,抑郁症是多发性硬化症的常见并发症,但在多发性痴呆症患者中研究不足。目的:评估1990名成人多发性硬化症患者的不良童年经历与抑郁症之间的关系。方法:参与者是Kaiser Permanente North California的成员,来自2006年至2021年间的两项研究,由神经学家诊断为多发性硬化症。使用包括行为危险因素监测系统在内的两种工具对儿童不良经历进行评估。参与者自我报告曾经历过严重的抑郁发作。荟萃分析随机效应模型和逻辑回归用于估计优势比(OR)和95%置信区间(CI),以评估研究样本中儿童不良经历与抑郁史之间的关系。儿童不良经历表示为任何/无、个别事件和计数。模型根据性别、出生年份、种族和民族进行了调整。结果:暴露于任何不良童年经历都会增加多发性硬化症患者患抑郁症的几率(OR:1.71,95%CI:1.21-2.42)。一些个体不良童年经历也与抑郁症密切相关,包括“严重的虐待或忽视”(or:2.79,95%CI:2.1-3.68)。结论:研究结果表明,多发性硬化症患者的不良童年经历与抑郁有关。应定期进行抑郁症筛查,尤其是在有不良童年经历的多发性硬化症患者中。