Chronic childhood adversity and onset of psychopathology during three life stages: childhood, adolescence and adulthood.
BACKGROUND
The aim is to report the individual and joint effects of a range of chronic childhood adversities on the first onset of a broad range of psychiatric disorders, and to evaluate their impact at different stages of the life course in a representative sample of the Mexican population.


METHODS
The data is from the Mexican National Comorbidity Survey (M-NCS), a stratified, multistage area probability sample of persons aged 18-65. The WHO World Mental Health Composite International Diagnostic Interview (WMH-CIDI) measured 12 childhood adversities, 20 psychiatric disorders and ages of onset. Discrete-time survival models were performed to estimate the odds of disorder onset.


RESULTS
In bivariate models, all adversities (except economic adversity and parental death) were significant predictors of psychopathology; however in multivariate models which correct for the clustering of adversities, family dysfunction and abuse adversities were the strongest and most consistent predictors of all four classes of psychopathologies examined (mood, anxiety, substance use and externalizing), and for the most part, over all three life course stages (childhood, adolescence and adulthood). The effect of the number of adversities was nonlinear such that although the odds of disorder onset increased with increasing numbers of adversities, the odds increased at a decreasing rate.


CONCLUSIONS
Childhood family dysfunction and abuse is a strong predictor of the onset of psychopathology throughout the life course, consistent with evidence for the enduring effects of chronic stress on brain structures involved in many psychiatric disorders and with stress-sensitization models of psychopathology.
Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico.
Corina
C
Benjet
Guilherme
G
Borges
María Elena
ME
Medina-Mora
D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D016241:Child of Impaired Parents / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D008960:Models, Psychological; D011599:Psychopathology / Q000379:methods*; D012307:Risk Factors; D055815:Young Adult