Association of Childhood Adversities and Early-Onset Mental Disorders With Adult-Onset Chronic Physical Conditions | Pediatrics | JAMA Psychiatry | JAMA Network
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Original Article
Aug 2011

Association of Childhood Adversities and Early-Onset Mental Disorders With Adult-Onset Chronic Physical Conditions

Author Affiliations

Author Affiliations: Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (Dr Scott); Group Health Research Institute, Seattle, Washington (Dr Von Korff); Center for Public Mental Health, Gösing am Wagram, Austria (Dr Angermeyer); National Institute of Psychiatry, Mexico City, Mexico (Dr Benjet); University Hospital Gasthuisberg, Leuven, Belgium (Dr Bruffaerts); Centro San Giovanni di Dio Fatebenefratelli, Istituto di Ricovero e Cura a Carattere Scientifico, Brescia, Italy (Dr de Girolamo); Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental, Sant Boi de Llobregat, Barcelona, Spain (Dr Haro); Hôpital Lariboisière Fernand Widal, Assistance Publique–Hôpitaux de Paris, University of Paris Diderot and University of Paris Descartes, Paris, France (Dr Lépine); Department of Psychiatry and Psychiatric Epidemiology, University Medical Center Groningen, University Center for Psychiatry, Groningen, Netherlands (Dr Ormel); Colegio Mayor de Cundinamarca University, Bogotá, Colombia (Dr Posada-Villa); National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan (Dr Tachimori); and Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (Dr Kessler).

Arch Gen Psychiatry. 2011;68(8):838-844. doi:10.1001/archgenpsychiatry.2011.77

Context The physical health consequences of childhood psychosocial adversities may be as substantial as the mental health consequences, but whether this is the case remains unclear because much prior research has involved unrepresentative samples and a selective focus on particular adversities or physical outcomes. The association between early-onset mental disorders and subsequent poor physical health in adulthood has not been investigated.

Objective To investigate whether childhood adversities and early-onset mental disorders are independently associated with increased risk of a range of adult-onset chronic physical conditions in culturally diverse samples spanning the full adult age range.

Design Cross-sectional community surveys of adults in 10 countries.

Setting General population.

Participants Adults (ie, aged≥18 years; N = 18 303), with diagnostic assessment and determination of age at onset of DSM-IV mental disorders, assessment of childhood familial adversities, and age of diagnosis or onset of chronic physical conditions.

Main Outcome Measures Risk (ie, hazard ratios) of adult-onset (ie, at age >20 years) heart disease, asthma, diabetes mellitus, arthritis, chronic spinal pain, and chronic headache as a function of specific childhood adversities and early-onset (ie, at age<21 years) DSM-IV depressive and anxiety disorders, with mutual adjustment.

Results A history of 3 or more childhood adversities was independently associated with onset of all 6 physical conditions (hazard ratios, 1.44 to 2.19). Controlling for current mental disorder made little difference to these associations. Early-onset mental disorders were independently associated with onset of 5 physical conditions (hazard ratios, 1.43 to 1.66).

Conclusions These results are consistent with the hypothesis that childhood adversities and early-onset mental disorders have independent, broad-spectrum effects that increase the risk of diverse chronic physical conditions in later life. They require confirmation in a prospectively designed study. The long course of these associations has theoretical and research implications.