title: The burden of child maltreatment in China: a systematic review.
abstract: OBJECTIVE
  To estimate the health and economic burdens of child maltreatment in China.
  
  
  METHODS
  We did a systematic review for studies on child maltreatment in China using PubMed, Embase, PsycInfo, CINAHL-EBSCO, ERIC and the Chinese National Knowledge Infrastructure databases. We did meta-analyses of studies that met inclusion criteria to estimate the prevalence of child neglect and child physical, emotional and sexual abuse. We used data from the 2010 global burden of disease estimates to calculate disability-adjusted life-years (DALYs) lost as a result of child maltreatment.
  
  
  RESULTS
  From 68 studies we estimated that 26.6% of children under 18 years of age have suffered physical abuse, 19.6% emotional abuse, 8.7% sexual abuse and 26.0% neglect. We estimate that emotional abuse in childhood accounts for 26.3% of the DALYs lost because of mental disorders and 18.0% of those lost because of self-harm. Physical abuse in childhood accounts for 12.2% of DALYs lost because of depression, 17.0% of those lost to anxiety, 20.7% of those lost to problem drinking, 18.8% of those lost to illicit drug use and 18.3% of those lost to self-harm. The consequences of physical abuse of children costs China an estimated 0.84% of its gross domestic product - i.e. 50 billion United States dollars - in 2010. The corresponding losses attributable to emotional and sexual abuse in childhood were 0.47% and 0.39% of the gross domestic product, respectively.
  
  
  CONCLUSIONS
  In China, child maltreatment is common and associated with large economic losses because many maltreated children suffer substantial psychological distress and might adopt behaviours that increase their risk of chronic disease.
authors.affiliation: Department of Applied Economics, College of Economics and Management, China Agricultural University, No. 17 Qinghuadong Road, Haidian District, Beijing, 100083, China .
authors.forename: Xiangming
authors.initials: X
authors.lastname: Fang
authors.affiliation: Moray House School of Education, University of Edinburgh, Edinburgh, Scotland .
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Fry
authors.affiliation: Crimes Against Children Research Center, University of New Hampshire, Durham, United States of America .
authors.forename: Kai
authors.initials: K
authors.lastname: Ji
authors.affiliation: Crimes Against Children Research Center, University of New Hampshire, Durham, United States of America .
authors.forename: David
authors.initials: D
authors.lastname: Finkelhor
authors.affiliation: Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China .
authors.forename: Jingqi
authors.initials: J
authors.lastname: Chen
authors.affiliation: Child Protection Program, UBS Optimus Foundation, Zurich, Switzerland .
authors.forename: Patricia
authors.initials: P
authors.lastname: Lannen
authors.affiliation: The Children and Youth Research Centre, Queensland University of Technology, Kelvin Grove, Australia .
authors.forename: Michael P
authors.initials: MP
authors.lastname: Dunne
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology; D001007:Anxiety / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data*; D002652:Child Behavior / Q000523:psychology; D000067576:Child Health / Q000191:economics / Q000706:statistics & numerical data; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D019057:Quality-Adjusted Life Years
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