title: Impact of childhood life events and trauma on the course of depressive and anxiety disorders.
abstract: OBJECTIVE
  Data on the impact of childhood life events and childhood trauma on the clinical course of depressive and anxiety disorders are limited.
  
  
  METHODS
  Longitudinal data were collected from 1209 adult participants in the Netherlands Study of Depression and Anxiety (NESDA). Childhood life events and trauma at baseline were assessed with a semi-structured interview and the clinical course after 2 years with a DSM-IV-based diagnostic interview and Life Chart Interview.
  
  
  RESULTS
  At baseline, 18.4% reported at least one childhood life event and 57.8% any childhood trauma. Childhood life events were not predictive of any measures of course trajectory. Emotional neglect, psychological and physical abuse, but not sexual abuse, were associated with persistence of both depressive and comorbid anxiety and depressive disorder at follow-up. Emotional neglect and psychological abuse were associated with a higher occurrence of a chronic course. Poor course outcomes were mediated mainly through a higher baseline severity of depressive symptoms.
  
  
  CONCLUSIONS
  Childhood trauma, but not childhood life events, was associated with an increased persistence of comorbidity and chronicity in adults with anxiety and/or depressive disorders. More unfavourable clinical characteristics at baseline mediate the relationship between childhood trauma and a poorer course of depressive and anxiety disorders.
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, the Netherlands. j.g.f.m.hovens@lumc.nl
authors.forename: J G F M
authors.initials: JG
authors.lastname: Hovens
authors.forename: E J
authors.initials: EJ
authors.lastname: Giltay
authors.forename: J E
authors.initials: JE
authors.lastname: Wiersma
authors.forename: P
authors.initials: P
authors.lastname: Spinhoven
authors.forename: B W J H
authors.initials: BW
authors.lastname: Penninx
authors.forename: F G
authors.initials: FG
authors.lastname: Zitman
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D009426:Netherlands; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index