Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis
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To determine whether depression and anxiety in adulthood are associated with abuse exposure in childhood.
A search of PUBMED, EMBASE and PSYCHINFO databases (2002–2012) was supplemented by hand searches of bibliographies of articles and reviews. We included studies contrasting abuse exposure vs. no-abuse exposure before age 16 years to depression and anxiety after age 16 years. Data on sample and exposure and outcome instruments, covariates and odds ratios (ORs) with the respective 95 % confidence intervals (CI) were extracted. Combined ORs and 95 % CI were calculated using random effects models. Heterogeneity was quantified using the I 2 test.
Inclusion criteria were met by 19 studies with 115,579 study participants, for assessing depression (n = 14) and anxiety (n = 13). The combined ORs for depression were 2.04 (95 % CI: 1.65–2.53) for sexual abuse and 1.49 (95 % CI: 1.29–1.72) for physical abuse. The combined ORs for anxiety were 2.52 (95 % CI: 2.12–2.98) for sexual abuse and 1.70 (95 % CI: 1.33–2.18) for physical abuse.
High levels of depression, anxiety and distress are reported in adults exposed to childhood sexual and physical abuse. These findings require increased awareness for the potential needs of adults exposed to child abuse and public health interventions to prevent child abuse.
KeywordsMeta-analysis Child abuse Depression Anxiety Life course
- American Psychiatric Association (APA), Composite International Diagnostic Interview 1.1. (CIDI) (1994) Researchers manual. APA, WashingtonGoogle Scholar
- Barth J, Bermetz L, Heim E, Trelle S, Tonia T (2012) The current prevalence of child sexual abuse worldwide: a systematic review and meta-analysis. Int J Public Health 58(3):460–483Google Scholar
- Centers for Disease Control and Prevention (2005) Centers for disease control and prevention, Department of Health and Human Services. Adverse childhood experiences study. http://www.cdc/nccdph/ACE/questionnaire.htm2008
- Cunningham H (1995) Children and childhood in Western society since 1500. Longman, LondonGoogle Scholar
- Draper B, Pfaff JJ, Pirkis J, Snowdon J, Lautenschlager NT, Wilson I et al (2008) Long-term effects of childhood abuse on the quality of life and health of older people: results from the depression and early prevention of suicide in general practice project. J Am Geriatr Soc 56(2):262–271PubMedCrossRefGoogle Scholar
- Kessler RC, Abelson J, Demler O, Escobar JI, Gibbon M, Guyer ME et al (2004) Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMHCIDI). Int J Methods Psychiatry Res 13(2):122–139CrossRefGoogle Scholar
- Knapman A, Kaltwasser SF, Martins-de-Souza D, Holsboer F, Landgraf R, Turck CW et al (2012) Increased stress reactivity is associated with reduced hippocampal activity and neuronal integrity along with changes in energy metabolism. Eur J Neurosci 35(3):412–422Google Scholar
- Lipsey M, Lipsey M, Wilson DB (2000) Practical meta-analysis. Sage, Thousand OaksGoogle Scholar
- Lovibond SH, Lovibond PF (1995) Manual for the Depression Anxiety Stress Scales. University of New South Wales, New South WalesGoogle Scholar
- Maier T, Mohler-Kuo M, Landolt MA, Schnyder U, Jud A (2013) The tip of the iceberg. Incidence of disclosed cases of child sexual abuse in Switzerland: results from a nationwide agency agency survey. Int J Public Health doi: 10.1007/s00038-013-0498-6
- McEwen BS (2003) Early life influences on life-long patterns of behavior and health. Ment Retard Develop Disabil Res Rev 9(3):149–154Google Scholar
- Spitzer RL, Williams JBW (1985) Structured clinical interview for DSM-III-R (SCID). NY Biometrics Research Dept. New York State Psychiatric Institute, New YorkGoogle Scholar
- Tonmyr L, Williams G, Hovdestad WE, Draca J (2011) Anxiety and/or depression in 10-15-year-olds investigated by child welfare in Canada. J Adolesc Health 48(5):493–498Google Scholar
- Wilczynski NL, Haynes RB (2003) Developing optimal search strategies for detecting clinically sound causation studies in MEDLINE. In: AMIA annual symposium proceedings, pp 719–723Google Scholar
- World Health Organization (1990) Composite International Diagnostic Interview (CIDI). http://www3.who.int/cidi. Accessed 13 Jan 2011
- World Health Organisation (1994) A user guide to the self reproting questionnaire (SRQ). World Health Organization Press, GenevaGoogle Scholar
- World Health Organization (2001) The world health report 2001—mental health: new understanding, new hope. World Health Organization Press, GenevaGoogle Scholar