Childhood physical abuse and respiratory disease in the community: the role of mental health and cigarette smoking.
BACKGROUND
Previous studies have found an association between child abuse and respiratory disease in some populations, but the mechanisms remain unknown, and this association has not been examined in a representative community-based sample. The goal of this study was to examine the relationship between childhood physical abuse and the odds of respiratory disease and to investigate the role of depression, anxiety, and pack-years of smoking in this association.


METHODS
Data were drawn from the Midlife Development in the United States Survey (n = 3,032), a representative sample of adults aged 25-74 years. Multiple logistic regression analyses were used to determine the association between childhood abuse and current respiratory disease (past 12 months) and to examine whether pack-years of smoking, depression, and anxiety disorders mediated the relationship.


RESULTS
Individuals who often experienced childhood abuse had a significantly increased odds of respiratory disease (odds ratio [OR] = 1.87 [1.21, 2.90]). The association was attenuated, after adjusting for demographic characteristics and pack-years of smoking, and was no longer significant after adjusting for depression and anxiety disorders.


CONCLUSIONS
These results are consistent with previous data suggesting a significant association between childhood abuse and respiratory disease and extend existing knowledge by providing initial evidence that demographic differences, depression and anxiety disorders, and lifetime cigarette smoking may mediate this observed relationship. Results require replication with longitudinal data in large community-based samples. Future studies that can explore potential biological mechanisms underlying the observed associations, such as immune factors, are needed next to better understand these relationships.
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1505, New York, NY 10032, USA. rdg66@columbia.edu
Renee D
RD
Goodwin
Frederick S
FS
Wamboldt
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications*; D001249:Asthma / Q000209:etiology / Q000523:psychology; D001991:Bronchitis / Q000209:etiology / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D003863:Depression / Q000150:complications*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016584:Panic Disorder / Q000150:complications*; D011656:Pulmonary Emphysema / Q000209:etiology / Q000523:psychology; D012140:Respiratory Tract Diseases / Q000209:etiology* / Q000523:psychology; D012189:Retrospective Studies; D057566:Self Report; D012907:Smoking / Q000009:adverse effects* / Q000523:psychology; D014481:United States