title: Association of childhood adversities with the first onset of mental disorders in Spain: results from the ESEMeD project.
abstract: OBJECTIVE
  Childhood adversities (CAs) have consistently been associated with mental health problems in childhood and adulthood. However, few studies have employed appropriate statistical methods that take into account overlap among CAs, and many of the ones that did so were based on insufficiently complex models. The present paper studies the prevalence of a wide variety of CAs, as well as their relationship to the onset of mental disorders in a representative sample of a Spanish population.
  
  
  METHODS
  The study is part of the ESEMeD-Spain project, a cross-sectional household survey, which included a nationally representative sample of the Spanish adult population. CAs' associations with lifetime prevalence of mental disorders were estimated using discrete-time survival analysis with person-years as the unit of analysis.
  
  
  RESULTS
  Of our sample, 20.6% reported at least one CA, of whom 24% reported more than one CA. Parental death, parental mental disorder, family violence, economic adversity, physical and sexual abuse were associated with different groups of mental disorders. CAs were associated with the onset of mental disorders during several stages of life. Simulations suggest that CAs were associated with 12.6% of all disorders, 10.8% of mood disorders, 5.8% of anxiety disorders, 27% of substance disorders and 29.7% of externalising disorders.
  
  
  CONCLUSIONS
  Prevalences of CAs in the Spanish population are lower than those found in other high-income countries, especially when compared to the USA. In Spain, different CAs were associated with the onset of a number of mental disorders, although these associations were not as frequent as in other countries. Although lower than in other countries, the association between CAs and mental health in Spain should be considered relevant. Specific health policies and prevention programmes are needed in order to decrease this burden.
authors.affiliation: Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Dr. Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain. jaume.perales@pssjd.org
authors.forename: Jaime
authors.initials: J
authors.lastname: Perales
authors.forename: Beatriz
authors.initials: B
authors.lastname: Olaya
authors.forename: Anna
authors.initials: A
authors.lastname: Fernandez
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Gemma
authors.initials: G
authors.lastname: Vilagut
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Forero
authors.forename: Luis
authors.initials: L
authors.lastname: San
authors.forename: José Angel
authors.initials: JA
authors.lastname: Alda
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D016241:Child of Impaired Parents / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008603:Mental Health; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult