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首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >Childhood Abuse and the Two-Year Course of Late-Life Depression
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Childhood Abuse and the Two-Year Course of Late-Life Depression

机译：童年虐待和两年的后期抑郁症课程

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Objectives: Late-life depression often has a chronic course, with debilitating effects on functioning and quality of life; there is still no consensus on important risk factors explaining this chronicity. Cross-sectional studies have shown that childhood abuse is associated with late-life depression, and in longitudinal studies with chronicity of depression in younger adults. We aim to investigate the impact of childhood abuse on the course of late-life depression. Design: Two-year longitudinal cohort study. Setting: Data were derived from the Netherlands Study of Depression in Older Persons (NESDO). Participants: 282 participants with a depression diagnosis in the previous 6 months (mean age: 70.6 years), of whom 152 (53.9%) experienced childhood abuse. Measurements: Presence of childhood abuse (yes/no) and a frequency-based childhood abuse index (CAI) were calculated. Dependent variable was depression diagnosis after 2 years. Results: Multivariable mediation analysis showed an association between childhood abuse and depression diagnosis at follow-up. Depression severity, age at onset, neuroticism, and number of chronic diseases were important mediating variables of this association, which then lost statistical significance. For childhood abuse (yes/no), loneliness was an additional, significant mediator. Depression severity was the main mediating variable, reducing the direct effect by 26.5% to 33.3% depending on the definition of abuse (respectively, 'yes/no" abuse and CAI). Conclusions: More depressive symptoms at baseline, lower age at depression onset, higher levels of neuroticism and loneliness, and more chronic diseases explain a poor course of depression in older adults who reported childhood abuse. When treating late-life depression it is important to detect childhood abuse and consider these mediating variables.
机译：目标：晚寿命抑郁症往往具有慢性课程，具有衰弱的作用和生活质量的影响;仍然没有关于解释这种慢性的重要风险因素的共识。横截面研究表明，儿童滥用与晚期抑郁症有关，纵向研究与较年轻成年人的抑郁症的慢性研究有关。我们的目标是调查童年滥用对晚生抑郁症过程的影响。设计：两年纵向队列研究。环境：数据来自荷兰对老年人抑郁症的研究（NESDO）。参与者：前6个月（意思是：70.6岁）的抑郁症诊断的参与者（意思是：70.6岁），其中152名（53.9％）经历过童年虐待。测量：计算童年滥用（是/否）和频率为频率的儿童虐待指数（CAI）。依赖变量在2年后抑郁症诊断。结果：多变量调解分析显示儿童虐待和随访抑郁症之间的关联。抑郁严重程度，年龄令人生意，神经质和慢性疾病的数量是这种关联的重要介导变量，从而丧失统计显着性。对于童年虐待（是/否），孤独是一个额外的重要的调解员。抑郁症严重程度是主要的调解变量，取决于滥用的定义（分别'是/否“滥用和蔡氏”的定义，将直接效应降低26.5％至33.3％。结论：抑郁症较低的基线抑郁症状，抑郁症较低，较高水平的神经骚扰和孤独，更慢性疾病在报告童年虐待的老年人中解释了一种较差的抑郁症过程。当治疗后期抑郁症时，重要的是发现儿童虐待并考虑这些中介变量很重要。

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