Izloženost psihičkoj traumatizaciji u detinjstvu kao faktor rizika za poremećaj afekta i za psihotične poremećaje
Sažetak
Sažetak
Uvod: Psihička traumatizacija u peridu detinjstva i rane adolescencije je zloupotreba ili zlostavljanje deteta starosti do 18 godina, koje obuhvata sve oblike fizičkog i/ili emocionalnog zlostavljanja i zanemarivanja, kao i seksualnu zloupotrebu, što dovodi do stvarnog ili potencijalnog narušavanja zdravlja i posledica koje uključuju različite psihijatrijske poremećaje.
Cilj: Cilj ovog istraživanja bio je ispitivanje povezanosti ove vrste traumatizacije sa depresivnošću, anksioznošću i doživljajem stresa u odraslom dobu kod opšte populacije, kao i poredjenje izloženosti psihičkoj traumi u detinjstvu između tri grupe ispitanika: opšte populacije, kliničke populacije sa dijagnozom afektivnih poremećaja i kliničke populacije sa dijagnozom psihoza iz shizofrenog sprektra.
Materijal i metode: U istraživanju je retrospektivno analizirana medicinska dokumentacija 179 odraslih ispitanika (zdravih kontrola 92, afektivnih poremećaja 35 i osoba sa psihozom 52), sa fokusom na podatke dobijene upitnicima za psihičku traumatizaciju u detinjstvu (CTQ), depresiju anksioznost i stres (DASS) i socio-demografske karatkteristike. U analizi podataka su primenjene metode deskriptivne statistike, testiranje razlika izmedju grupa i analiza korelacija.
Rezultati: Kod zdravih ispitanika, uočena je pozitivna korelacija dečje traumatizacije i rezultata DASS (skala depresivnosti, anksioznosti i stresa) (r=0,265, p=0,013). U odnosu na vrstu traumatizacije, u ovoj grupi ispitanika uočeno je da je subdepresivnost bila najjače povezana sa emocionalnim zlostavljanjem (β=0,427, p=0,003), dok ostali oblici traume u detinjstvu nisu uticali na DASS u odraslom dobu.. Ukupni ukupni rezultat traumatizacije nije se razlikovao kod osoba sa psihozom u odnosu na osobe sa afektivnim poremećajima. U odnosu na kontrolnu grupu, kod psihoza je uočeno više emocionalnog i seksualnog zlostavljanja, kao i emocionalnog i fizičkog zanemarivanja (p<0,05). Kod afektivnih poremećaja jedino seksualnog zlostavljanja nije bilo više u odnosu na kontrolnu grupu (p=0,390).
Zaključak: Aktuelno istraživanje obezbedilo je uvid da je učestala psihička traumatizacija u detinjstvu prisutna kod pacijenata sa afektivnim i psihotičnim poremećajima, pa je treba posmatrati kao zajednički faktor rizika u etiologiji navedenih poremećaja. Blagovremeno otkrivanje traumatizacije u detinjstvu i sprečavanje posledica pravovremenim intervencijama su važne mere u prevenciji mentalnih poremećaja odraslog doba.
Ključne reči: trauma, depresija, psihoza, prevencija
Abstract
Introduction: Traumatic experiences in childhood include maltreatment of an individua aged up to 18, which comprises all kinds of physical and/or emotional abuse and physical and/or emotional neglect, as well as sexual abuse, which lead to the real or potential health hazard.
Aim: The aim of present research was to examine the relationship of childhood trauma with symptoms of depression, anxiety and stress in the general population, as well as to compare the exposure to childhood trauma among the three groups of subjects: non-clinical population, clinical population with affective disorders and clinical population with schizophrenia spectrum psychosis.
Materials and methods: Medical documentation of 179 adult subjects (healthy controls 92, affective disorders 35 and subjects with psychosis 52) was retrospectively analyzed, using Childhood Trauma Questionnaire, Depression Anxiety Stress Scale and socio-demographic data. Methods of descriptive statistics, between group differences and correlation analysis were applied for the purpose of the data analysis.
Results: In the non-clinical sample, a positive correlation between childhood trauma and DASS (depression, anxiety and stress scale) has been noticed (r=0,265, p=0,013). When subtypes of trauma were analyzed in this group, it has been noticed that emotional abuse was associated with sub-depression (β=0,427, p=0,003), whereas other types of childhood trauma did not influence DASS scores significantly.
In addition, we showed that the overall level of trauma did not differ between subjects with psychosis and those with affective disorders. In comparison to the control group, subjects with psychosis had more emotional and sexual abuse, alongside more emotional and physical neglect (p<0,05). In affective disorders, only sexual abuse was not higher in comparison to the control group (p=0,390). Conclusion: This research focused on exposure to childhood trauma in patients with affective and psychotic disorders, showing that early adversities have to be considered as a common risk factor in the etiology of the aforementioned disorders. A timely identification of traumatization in childhood and prevention of its consequences by early interventions are important goals of the prevention of mental diroders in adulthood.
Key words: trauma, depression, psychosis, prevention.
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