title: Association of childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Cross-sectional community surveys of adults in 10 countries.
  
  
  METHODS
  General population.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. kate.scott@otago.ac.nz
authors.forename: Kate M
authors.initials: KM
authors.lastname: Scott
authors.forename: Michael
authors.initials: M
authors.lastname: Von Korff
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Angermeyer
authors.forename: Corina
authors.initials: C
authors.lastname: Benjet
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lépine
authors.forename: Johan
authors.initials: J
authors.lastname: Ormel
authors.forename: José
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: Hisateru
authors.initials: H
authors.lastname: Tachimori
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D017668:Age of Onset; D003430:Cross-Sectional Studies; D005192:Family Health; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors