title: Gender-specific association between childhood trauma and rheumatoid arthritis: a case-control study.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) has been associated with a variety of emotional stressors, but findings remain inconclusive if RA is related to childhood trauma, which is known to have long-lasting negative consequences for physical health decades into adulthood. We investigated the association between childhood trauma and RA by comparing histories of child abuse and neglect between RA patients and adults from the general population in a cross-sectional case-control study.
  
  
  METHODS
  331 patients with definite RA and 662 gender- and age-matched adults from the general population were administered the self-report Childhood Trauma Questionnaire (CTQ) for the assessment of emotional, physical and sexual abuse as well as emotional and physical neglect.
  
  
  RESULTS
  Adjusting for gender and current depression, RA patients scored significantly higher in all CTQ subscales apart from sexual abuse and physical neglect than the controls. Adjusted odds ratios for these types of childhood trauma were higher in the RA group than in controls ranging from 2.0 for emotional neglect (95% confidence interval [CI]: 1.4-3.0) to 2.6 for emotional abuse (95% CI: 1.4-4.7). Gender-specific analyses revealed basically the same pattern for women, but not for men.
  
  
  CONCLUSIONS
  Our findings suggest an association between childhood trauma and development of RA, particularly in women. This relationship may be mediated by dysregulations of neuro-endocrine-immune networks, but larger prospective studies are needed to clarify the association between early life stress and the risk for RA in genetically susceptible individuals.
authors.affiliation: Asklepios Fachklinikum Tiefenbrunn, Göttingen, Germany. c.spitzer@asklepios.com
authors.forename: Carsten
authors.initials: C
authors.lastname: Spitzer
authors.forename: Stefanie
authors.initials: S
authors.lastname: Wegert
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wollenhaupt
authors.forename: Katja
authors.initials: K
authors.lastname: Wingenfeld
authors.forename: Sven
authors.initials: S
authors.lastname: Barnow
authors.forename: Hans Joergen
authors.initials: HJ
authors.lastname: Grabe
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000209:etiology* / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012737:Sex Factors; D011795:Surveys and Questionnaires