International Journal of Public Health

, Volume 59, Issue 2, pp 359–372 | Cite as

Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis

  • Jutta LindertEmail author
  • Ondine S. von Ehrenstein
  • Rachel Grashow
  • Gilad Gal
  • Elmar Braehler
  • Marc G. Weisskopf



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.


Meta-analysis Child abuse Depression Anxiety Life course 


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Copyright information

© Swiss School of Public Health 2013

Authors and Affiliations

  • Jutta Lindert
    • 1
    • 2
    • 3
    Email author
  • Ondine S. von Ehrenstein
    • 4
  • Rachel Grashow
    • 3
  • Gilad Gal
    • 5
  • Elmar Braehler
    • 2
  • Marc G. Weisskopf
    • 3
    • 6
  1. 1.Department of Public HealthProtestant University of LudwigsburgLudwigsburgGermany
  2. 2.Department for Medical Psychology and Medical Sociology, Faculty of MedicineUniversity of LeipzigLeipzigGermany
  3. 3.Department of Environmental HealthHarvard School of Public HealthBostonUSA
  4. 4.Fielding School of Public HealthUniversity of California Los AngelesLos AngelesUSA
  5. 5.School of Behavioral SciencesThe Academic College Tel Aviv-YaffoTel AvivIsrael
  6. 6.Department of EpidemiologyHarvard School of Public HealthBostonUSA

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