title: Are there associations between early emotional trauma and anxiety disorders? Evidence from a systematic literature review and meta-analysis.
abstract: BACKGROUND
  Previous studies indicate a possible association between early emotional trauma (EET) and the development of anxiety disorders (ADs) in adult life. However, no previous studies have compiled the findings of such studies and analyzed their statistical significance. Therefore, the objective of this study was to conduct a systematic literature review and meta-analysis to determine possible associations between EET and three ADs (panic, generalized anxiety, and social anxiety disorders).
  
  
  METHODS
  A systematic search was conducted in PubMed, PsycInfo, and Scielo with no publication date limitations. A total of 2127 studies were found, 32 studies of which were selected for the systematic review and 13 studies of which were selected for the meta-analysis.
  
  
  RESULTS
  High prevalence rates of different EETs were observed among the individuals with ADs (median: 18%-45%). The results of the meta-analysis indicated that individuals with EETs were 1.9- to 3.6-fold more likely to develop ADs compared with a control group of healthy individuals. Emotional traumas were the main risk factor for social anxiety disorder. However, no specific associations were found for the other ADs.
  
  
  CONCLUSIONS
  EET is a risk factor for ADs, underscoring the importance of preventive measures to combat the development of these disorders. Moreover, the identification of EETs among patients with ADs is essential for implementing remedial measures to minimize the impact and damage arising from this association by decreasing the risk and severity of symptoms and to improve the response rate to treatment of ADs.
authors.affiliation: Department of neurosciences and behavior, Medical School of Ribeirão Preto, university of São Paulo, 3900, avenida dos Bandeirantes, CEP 14048-900, Ribeirão Preto, São Paulo, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Fernandes
authors.affiliation: Department of neurosciences and behavior, Medical School of Ribeirão Preto, university of São Paulo, 3900, avenida dos Bandeirantes, CEP 14048-900, Ribeirão Preto, São Paulo, Brazil; Technology Institute (INCT, CNPq) for Translational Medicine, Brazil. Electronic address: flaliosorio@ig.com.br.
authors.forename: F L
authors.initials: FL
authors.lastname: Osório
mesh_terms: D000328:Adult; D017668:Age of Onset; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D002648:Child; D006801:Humans; D015995:Prevalence; D000067073:Psychological Trauma / Q000150:complications / Q000453:epidemiology; D011599:Psychopathology; D012307:Risk Factors; D013315:Stress, Psychological / Q000523:psychology
keywords: Anxiety; Early emotional trauma; Generalized anxiety; Meta-analysis; Panic; Social anxiety