Childhood Exposure to Psychological Trauma and the Risk of Suicide Attempts: The Modulating Effect of Psychiatric Disorders
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
ObjectiveaaWe examined whether childhood exposure to psychological trauma is associated with greater suicidality and whether specific psychiatric disorders modulate this association in a representative sample of Korean adults. MethodsaaThe Korean version of the Composite International Diagnostic Interview 2.1 was administered to 6,027 subjects aged 18–74 years. Subjects who experienced a traumatic event before the age of 18 years, the childhood-trauma-exposure group, were compared with controls without childhood trauma exposure. ResultsaaChildhood exposure to psychological trauma was associated with lifetime suicidal ideation (OR=3.19, 95% CI=2.42–4.20), suicide plans (OR=4.15, 95% CI=2.68–6.43), and suicide attempts (OR=4.52, 95% CI=2.97–6.88). These associations weakened after further adjustment for any psychiatric disorders, but they were not eliminated. The risk of suicide attempts related to childhood trauma increased with the presence of a concurrent alcohol use, depressive, or eating disorder. ConclusionaaIn terms of clinical implications, patients with these disorders who have a history of childhood trauma should be carefully assessed for their suicide risk and aggressively treated for psychiatric disorders.
Abstract
ObjectiveaaWe examined whether childhood exposure to psychological trauma is associated with greater suicidality and whether specific psychiatric disorders modulate this association in a representative sample of Korean adults. MethodsaaThe Korean version of the Composite International Diagnostic Interview 2.1 was administered to 6,027 subjects aged 18–74 years. Subjects who experienced a traumatic event before the age of 18 years, the childhood-trauma-exposure group, were compared with controls without childhood trauma exposure. ResultsaaChildhood exposure to psychological trauma was associated with lifetime suicidal ideation (OR=3.19, 95% CI=2.42–4.20), suicide plans (OR=4.15, 95% CI=2.68–6.43), and suicide attempts (OR=4.52, 95% CI=2.97–6.88). These associations weakened after further adjustment for any psychiatric disorders, but they were not eliminated. The risk of suicide attempts related to childhood trauma increased with the presence of a concurrent alcohol use, depressive, or eating disorder. ConclusionaaIn terms of clinical implications, patients with these disorders who have a history of childhood trauma should be carefully assessed for their suicide risk and aggressively treated for psychiatric disorders.
참고문헌 (19)
- OECD, "Health at a Glance 2013: OECD Indicators" (2013), OECD Publishing
- Dube SR, "Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study", JAMA, 286, pp.3089~3096 (2001)
- Jeon HJ, "Early trauma and lifetime suicidal behavior in a nationwide sample of Korean medical students", J Affect Disord, 119, pp.210~214 (2009)
- Molnar BE, "Psychopathology, childhood sexual abuse and other childhood adversities: relative links to subsequent suicidal behaviour in the US", Psychol Med, 31, pp.965~977 (2001)
- Ferreira de Castro E, "Parasuicide and mental disorders", Acta Psychiatr Scand, 97, pp.25~31 (1998)
- Haw C, "Deliberate self-harm patients with alcohol disorders: characteristics, treatment, and outcome", Crisis, 22, pp.93~101 (2001)
- Finkelhor D, "Polyvictimization and trauma in a national longitudinal cohort", Dev Psychopathol, 19, pp.149~166 (2007)
- Kessler RC, "Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey", Psychol Med, 27, pp.1101~1119 (1997)
- Edwards VJ, "Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study", Am J Psychiatry, 160, pp.1453~1460 (2003)
- McLaughlin KA, "Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCS-R) III: associations with functional impairment related to DSM-IV disorders", Psychol Med, 40, pp.847~859 (2010)
- Bedi S, "Risk for suicidal thoughts and behavior after childhood sexual abuse in women and men", Suicide Life Threat Behav, 41, pp.406~415 (2011)
- Cho MJ, "Lifetime and 12-month prevalence of DSM-IV psychiatric disorders among Korean adults", J Nerv Ment Dis, 195, pp.203~210 (2007)
- Cho MJ, "Prevalence of DSM-IV major mental disorders among Korean adults: a 2006 National Epidemiologic Survey (KECA-R)", Asian J Psychiatr, 3, pp.26~30 (2010)
- 조맹제, "한국어판 Composite International Diagnostic Interview(K-CIDI)의 개발", 신경정신의학, 41(1) (2002), 대한신경정신의학회
- World Health Organization, "Composite International Diagnostic Interview (CIDI), Version 1.0" (1990), World Health Organization
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders, Text Revision" (2000), American Psychiatric Association
- World Health Organization, "Procedures for the Development of New Language Versions of the WHO Composite International Diagnostic Interview (WHO-CIDI)" (1997), World Health Organization
- Fergusson DM, "Childhood sexual abuse and psychiatric disorder in young adulthood: II. Psychiatric outcomes of childhood sexual abuse", J Am Acad Child Adolesc Psychiatry, 35, pp.1365~1374 (1996)
- Martin G, "Sexual abuse and suicidality: genderdifferences in a large community sample of adolescents", Child Abuse Negl, 28, pp.491~503 (2004)