Association of Childhood Adversities and Early-Onset Mental Disorders With Adult-Onset Chronic Physical Conditions

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Abstract
The deleterious mental health consequences of childhood psychosocial adversities, such as abuse and neglect, have been well documented.1 Although less extensively researched, childhood adversities have been hypothesized to increase the risk of adult onset of a spectrum of chronic physical diseases.2,3 A recent meta-analysis4 of the effects of child abuse on medical outcomes in adulthood reached that exact conclusion, finding that the increased risk of selected adverse physical health outcomes was comparable to that observed for poor mental health outcomes. However, the evidence base for the association of child maltreatment with subsequent physical health has significant limitations, which include lack of control for the potentially biasing effects of current mental disorder on recall of childhood adversities, a predominant focus on a single adversity (ie, sexual abuse), and a lack of sample diversity in terms of race/ethnicity (ie, mostly white), age (ie, mostly young adults), and sex (ie, mostly female). The relatively young age of current prospective cohorts with childhood maltreatment data is a particular limitation because it greatly restricts the range of disease outcomes studied and truncates the full expression of disease risk, potentially biasing findings toward the null.

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