title: Childhood maltreatment and eating disorder pathology: a systematic review and dose-response meta-analysis.
abstract: BACKGROUND
  Meta-analyses have established a high prevalence of childhood maltreatment (CM) in patients with eating disorders (EDs) relative to the general population. Whether the prevalence of CM in EDs is also high relative to that in other mental disorders has not yet been established through meta-analyses nor to what extent CM affects defining features of EDs, such as number of binge/purge episodes or age at onset. Our aim is to provide meta-analyses on the associations between exposure to CM (i.e. emotional, physical and sexual abuse) on the occurrence of all types of EDs and its defining features.
  
  
  METHODS
  Systematic review and meta-analyses. Databases were searched until 4 June 2016.
  
  
  RESULTS
  CM prevalence was high in each type of ED (totalN= 13 059, prevalence rates 21-59%) relative to healthy (N= 15 092, prevalence rates 1-35%) and psychiatric (N= 7736, prevalence rates 5-46%) control groups. ED patients reporting CM were more likely to be diagnosed with a co-morbid psychiatric disorder [odds ratios (ORs) range 1.41-2.46,p< 0.05] and to be suicidal (OR 2.07,p< 0.001) relative to ED subjects who were not exposed to CM. ED subjects exposed to CM also reported an earlier age at ED onset [effect size (Hedges'g) = -0.32,p< 0.05], to suffer a more severe form of the illness (g= 0.29,p< 0.05), and to binge-purge (g= 0.31,p< 0.001) more often compared to ED patients who did not report any CM.
  
  
  CONCLUSIONS
  CM, regardless of type, is associated with the presence of all types of ED and with severity parameters that characterize these illnesses in a dose dependent manner.
authors.affiliation: Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands.|Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M L
authors.initials: ML
authors.lastname: Molendijk
authors.affiliation: Parnassia Psychiatric Institute, The Hague, The Netherlands.|Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.|Department of Epidemiology, Columbia University, New York, USA.
authors.forename: H W
authors.initials: HW
authors.lastname: Hoek
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Brewerton
authors.affiliation: Institute of Psychology, Clinical Psychology Unit, Leiden University, Leiden, The Netherlands.|Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: B M
authors.initials: BM
authors.lastname: Elzinga
keywords: Anorexia; bulimia; childhood abuse; eating disorders; meta-analysis