title: Childhood trauma in multiple sclerosis: a case-control study.
abstract: OBJECTIVE
  To investigate the association between childhood trauma and multiple sclerosis (MS) by comparing histories of child abuse and neglect between patients with MS and adults from the general population in a cross-sectional case-control study. Previous research has demonstrated a connection between MS and a variety of emotional stressors, but childhood trauma, which is known to have long-lasting negative consequences for physical health decades into adulthood, has not been studied.
  
  
  METHODS
  The self-reported Childhood Trauma Questionnaire for the assessment of emotional, physical, and sexual abuse and emotional and physical neglect was administered to 234 patients with definite MS and 885 adults from the general population.
  
  
  RESULTS
  After adjusting for sociodemographic factors and current depression, patients with MS scored significantly higher in all Childhood Trauma Questionnaire subscales apart from physical abuse and neglect than adults from the general population. Adjusted odds ratios for these types of childhood trauma were higher in the MS group than in controls, ranging from 2.0 for emotional neglect (95% confidence interval = 1.3-3.2) to 3.4 for emotional abuse (95% confidence interval = 2.0-5.7). Although childhood trauma was not associated with the degree of current MS-related disability, patients with MS with histories of physical and/or sexual abuse had significantly higher relapse rates than patients without early-life stress.
  
  
  CONCLUSIONS
  Our findings suggest an association between childhood trauma and MS in this cross-sectional study. Larger prospective longitudinal studies are needed to clarify the relationship between early-life stress and the risk for MS in genetically susceptible individuals.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek, Martinistr. 52, 20246 Hamburg, Germany. c.spitzer@uke.uni-hamburg.de
authors.forename: Carsten
authors.initials: C
authors.lastname: Spitzer
authors.forename: Miriam
authors.initials: M
authors.lastname: Bouchain
authors.forename: Liza Y
authors.initials: LY
authors.lastname: Winkler
authors.forename: Katja
authors.initials: K
authors.lastname: Wingenfeld
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Gold
authors.forename: Hans Joergen
authors.initials: HJ
authors.lastname: Grabe
authors.forename: Sven
authors.initials: S
authors.lastname: Barnow
authors.forename: Christian
authors.initials: C
authors.lastname: Otte
authors.forename: Christoph
authors.initials: C
authors.lastname: Heesen
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000706:statistics & numerical data*; D017668:Age of Onset; D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000235:genetics; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult