Childhood adversity and vulnerability to mood and anxiety disorders.
Based upon epidemiological surveys, adverse childhood events are proposed to be risk factors for adult depressive and anxiety disorders. However, the extent to which these events are seen in clinical patient populations is less clear. We examined the prevalence of a number of proposed risk factors for depression in 650 patients with mood and anxiety disorders at the time of presentation for treatment in an outpatient subspecialty clinic. Emotional abuse, physical abuse, or sexual abuse (childhood adversity) was found in approximately 35% of patients with major depression and panic disorder, was more common in women than men, and was associated with an earlier onset of symptoms. Childhood adversity was also strongly associated with marital discord/divorce, and psychopathology in a parent, suggesting family discord predisposes to childhood abuse. Furthermore, the association of childhood abuse with parental mental illness suggests that genetic and environmental factors are difficult to separate as etiological factors in vulnerability.
Young
E A
EA
Department of Psychiatry and Mental Health Research Institute, University of Michigan, Ann Arbor, USA.
Abelson
J L
JL
Curtis
G C
GC
Nesse
R M
RM
D000328:Adult; D017668:Age of Onset; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D016009:Chi-Square Distribution; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D016241:Child of Impaired Parents / Q000523:psychology / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000523:psychology; D004198:Disease Susceptibility; D005192:Family Health; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008824:Michigan / Q000453:epidemiology; D019964:Mood Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D016584:Panic Disorder / Q000523:psychology; D010698:Phobic Disorders / Q000523:psychology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000150:complications