Social Psychiatry and Psychiatric Epidemiology

, Volume 40, Issue 10, pp 769–777

Childhood adversities as risk factors for adult mental disorders

Results from the Health 2000 study
  • Sami Pirkola
  • Erkki Isometsä
  • Hillevi Aro
  • Laura Kestilä
  • Juha Hämäläinen
  • Juha Veijola
  • Olli Kiviruusu
  • Jouko Lönnqvist
Original Paper



The sex-specific role of stressful or traumatic childhood experiences and adverse circumstances in developing adulthood mental disorders is complex and still in need of comprehensive research.


Within the Health 2000 project in Finland, a representative sample of 4,076 subjects aged 30–64 years were investigated to examine associations between a set of retrospectively self-reported adverse environmental factors during childhood (0–16 years) and mental disorders diagnosed in the past 12 months by the Munich Composite International Diagnostic Interview.


Of the 60% of adults reporting at least one childhood adversity, 17% had a current (past 12 months) mental disorder, compared to 10% of the non-reporters. A moderate dose–response relationship between the total number of adversities and current disorders was observed. Paternal mental health problems associated particularly strongly with male depressive disorders (OR 4.46), and maternal mental health problems with female depressive disorders (OR 3.20). Although seldom reported, maternal alcohol problems associated with alcohol use disorders in both sexes. Being bullied at school and childhood family discord predicted a variety of adulthood disorders in both sexes. All these four adversity items were more typical for depressive disorders with an earlier onset. Among females, more adversities were associated with mental disorders and their statistical significance was greater than among males.


There are marked sex differences and several diagnosis-related patterns in the associations between reported childhood experiences and environmental circumstances and adulthood mental disorders. The impact of adversities is probably composed of a wide range of factors from direct causal associations to complex, interacting environmental effects. Variations in the reported associations reflect the differing genetic and environmental transmission mechanisms of mental disorders.

Key words

mental disorders life change events risk factors environmental childhood 


  1. 1.
    Pirkola S, Isometsä E, Suvisaari J et al (2005) DSM-IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population. Results from the Health 2000 study. Soc Psychiatry Psychiatr Epidemiol 40:1–10PubMedGoogle Scholar
  2. 2.
    de Graaf R, Bijl RV, Smit F, Vollebergh WA, Spijker J (2002) Risk factors for 12-month comorbidity of mood, anxiety, and substance use disorders: findings from the Netherlands Mental Health Survey and Incidence Study. Am J Psychiatry 159:620–629PubMedGoogle Scholar
  3. 3.
    Kessler RC, Nelson CB, McGonagle KA, Liu J, Swartz M, Blazer DG (1996) Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US National Comorbidity Survey. Br J Psychiatry Suppl 17–30Google Scholar
  4. 4.
    Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, Girolamo G, Graaf R, Demyttenaere K, Gasquet I, Haro JM, Katz SJ, Kessler RC, Kovess V, Lepine JP, Ormel J, Polidori G, Russo LJ, Vilagut G, Almansa J, Arbabzadeh-Bouchez S, Autonell J, Bernal M, Buist-Bouwman MA, Codony M, Domingo-Salvany A, Ferrer M, Joo SS, Martinez-Alonso M, Matschinger H, Mazzi F, Morgan Z, Morosini P, Palacin C, Romera B, Taub N, Vollebergh WAM (2004) Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand 109:21–27CrossRefGoogle Scholar
  5. 5.
    Mäkikyro T, Sauvola A, Moring J et al (1998) Hospital-treated psychiatric disorders in adults with a single-parent and two-parent family background: a 28-year follow-up of the 1966 Northern Finland Birth Cohort. Fam Process 37:335–344PubMedGoogle Scholar
  6. 6.
    Sauvola A, Räsänen PK, Joukamaa MI, Jokelainen J, Jarvelin MR, Isohanni MK (2001) Mortality of young adults in relation to single-parent family background. A prospective study of the northern Finland 1966 birth cohort. Eur J Public Health 11:284–286CrossRefPubMedGoogle Scholar
  7. 7.
    Warner V, Mufson L, Weissman MM (1995) Offspring at high and low risk for depression and anxiety: mechanisms of psychiatric disorder. J Am Acad Child Adolesc Psychiatry 34:786–797PubMedGoogle Scholar
  8. 8.
    Dierker LC, Merikangas KR, Szatmari P (1999) Influence of parental concordance for psychiatric disorders on psychopathology in offspring. J Am Acad Child Adolesc Psychiatry 38:280–288PubMedGoogle Scholar
  9. 9.
    Marmorstein NR, Malone SM, Iacono WG (2004) Psychiatric disorders among offspring of depressed mothers: associations with paternal psychopathology. Am J Psychiatry 161:1588–1594CrossRefPubMedGoogle Scholar
  10. 10.
    Kessler RC, Davis CG, Kendler KS (1997) Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychol Med 27:1101–1119PubMedGoogle Scholar
  11. 11.
    Veijola J, Puukka P, Lehtinen V, Moring J, Lindholm T, Väisänen E (1998) Sex differences in the association between childhood experiences and adult depression. Psychol Med 28:21–27CrossRefPubMedGoogle Scholar
  12. 12.
    McLeod JD (1991) Childhood parental loss and adult depression. J Health Soc Behav 32:205–220PubMedGoogle Scholar
  13. 13.
    Rodgers B (1994) Pathways between parental divorce and adult depression. J Child Psychol Psychiatry 35:1289–1308PubMedGoogle Scholar
  14. 14.
    Kessler RC (2003) Epidemiology of women and depression. J Affect Disord 74:5–13CrossRefPubMedGoogle Scholar
  15. 15.
    Reiss D, Cederblad M, Pedersen NL et al (2001a) Genetic probes of three theories of maternal adjustment. II. Genetic and environmental influences. Fam Process 40:261–272PubMedGoogle Scholar
  16. 16.
    Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, Anda RF (2004) Adverse childhood experiences and the risk of depressive disorders in adulthood. J Affect Disord 82:217–225CrossRefPubMedGoogle Scholar
  17. 17.
    Anda RF, Whitfield CL, Felitti VJ et al (2002) Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatr Serv 53:1001–1009CrossRefPubMedGoogle Scholar
  18. 18.
    Caspi A, McClay J, Moffitt TE et al (2002) Role of genotype in the cycle of violence in maltreated children. Science 297:851–854CrossRefPubMedGoogle Scholar
  19. 19.
    Kendler KS, Prescott CA, Myers J, Neale MC (2003) The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Arch Gen Psychiatry 60:929–937PubMedGoogle Scholar
  20. 20.
    Kendler KS, Hettema JM, Butera F, Gardner CO, Prescott CA (2003) Life event dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets of major depression and generalized anxiety. Arch Gen Psychiatry 60:789–796PubMedGoogle Scholar
  21. 21.
    Foley DL, Eaves LJ, Wormley B et al (2004) Childhood adversity, monoamine oxidase a genotype, and risk for conduct disorder. Arch Gen Psychiatry 61:738–744PubMedGoogle Scholar
  22. 22.
    Marmorstein NR, Iacono WG (2004) Major depression and conduct disorder in youth: associations with parental psychopathology and parent–child conflict. J Child Psychol Psychiatry 45:377–386CrossRefPubMedGoogle Scholar
  23. 23.
    Reiss D, Pedersen NL, Cederblad M et al (2001b) Genetic probes of three theories of maternal adjustment. I. Recent evidence and a model. Fam Process 40:247–259PubMedGoogle Scholar
  24. 24.
    Aromaa A, Koskinen SE (2004) Health and functional capacity in Finland. Baseline results of the Health 2000 Health Examination Survey, vol. B12/2004. 2004 Publications of the National Public Health Institute. Hakapaino Oy, HelsinkiGoogle Scholar
  25. 25.
    International Consortium in Psychiatric Epidemiology (2000) Cross-national comparisons of the prevalences and correlates of mental disorders. Bull WHO 78:413–426Google Scholar
  26. 26.
    Caspi A, Sugden K, Moffitt TE et al (2003) Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 301:386–389CrossRefPubMedGoogle Scholar
  27. 27.
    Caspi A, Taylor A, Moffitt TE, Plomin R (2000) Neighborhood deprivation affects children's mental health: environmental risks identified in a genetic design. Psychol Sci 11:338–342CrossRefPubMedGoogle Scholar
  28. 28.
    Wainwright NW, Surtees PG (2002) Childhood adversity, gender and depression over the life-course. J Affect Disord 72:33–44CrossRefPubMedGoogle Scholar
  29. 29.
    Lieb R, Isensee B, Hofler M, Wittchen HU (2002) Parental depression and depression in offspring: evidence for familial characteristics and subtypes? J Psychiatr Res 36:237–246CrossRefPubMedGoogle Scholar
  30. 30.
    Levitan RD, Rector NA, Sheldon T, Goering P (2003) Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: issues of co-morbidity and specificity. Depress Anxiety 17:34–42CrossRefPubMedGoogle Scholar
  31. 31.
    Bijl RV, Cuijpers P, Smit F (2002) Psychiatric disorders in adult children of parents with a history of psychopathology. Soc Psychiatry Psychiatr Epidemiol 37:7–12PubMedGoogle Scholar
  32. 32.
    Kaltiala-Heino R, Rimpelä M, Marttunen M, Rimpelä A, Rantanen P (1999) Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. BMJ 319:348–351PubMedGoogle Scholar
  33. 33.
    Wolkind S, Coleman EZ (1983) Adult psychiatric disorder and childhood experiences. The validity of retrospective data. Br J Psychiatry 143:188–191PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Sami Pirkola
    • 1
    • 2
  • Erkki Isometsä
    • 1
    • 3
  • Hillevi Aro
    • 1
  • Laura Kestilä
    • 4
  • Juha Hämäläinen
    • 1
  • Juha Veijola
    • 5
  • Olli Kiviruusu
    • 1
  • Jouko Lönnqvist
    • 1
    • 3
  1. 1.Dept. of Mental Health and Alcohol ResearchNational Public Health Institute (KTL)HelsinkiFinland
  2. 2.Health and Social Services DivisionSTAKES (National Research and Development Centre for Welfare and Health)HelsinkiFinland
  3. 3.Dept. of PsychiatryUniversity of HelsinkiHelsinkiFinland
  4. 4.Dept. of Health and Functional CapacityNational Public Health InstituteHelsinkiFinland
  5. 5.Dept. of PsychiatryUniversity of Oulu and Muurola Hospital, Hospital District of LaplandOsloFinland

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