Tuesday, January 02, 2007

Physical abuse leads to adult depression

From The Awareness Center's Daily Newsletter

Physical abuse leads to adult depression - US study
January 1, 2007

CHICAGO, Jan 1 (Reuters) - Physically abused and neglected children are much more likely to grow into severely depressed adults, a finding that researchers said on Monday points to an urgent need to test abused children for depression early on.

Physically abused children have a 59 percent increased risk of lifetime major depression compared with similar children who were not abused, said the study in this month's issue of the Archives of General Psychiatry.

Earlier studies had linked childhood abuse with serious depression but researchers said this study is the first to show that depression is a consequence of the abuse.

"These results underscore the need to detect and treat the long-term psychological (effects) of childhood neglect," wrote lead researcher Cathy Spatz Widom, who was with the New Jersey Medical School in Newark when she worked on the study.

Researchers compared about 680 children who were abused and neglected before the age of 11 with 520 children of similar age, race, sex, and social status. Both groups were followed into young adulthood, up to an average age of 29.

Children who were physically abused, neglected or both had as much as a 75 percent higher risk of suffering major depression as adults.

"In addition, these findings reveal that onset of depression began in childhood for many of the children," the report said.

A Prospective Investigation of Major Depressive Disorder and Comorbidity in Abused and Neglected Children Grown Up
by Cathy Spatz Wid; Kimberly Du; Sally J. C
Arch Gen Psychiatry. 2007;64:49-56.

Context Few prospective longitudinal studies have examined the relationship between abuse or neglect in childhood and depression in adulthood.

Objective To determine whether abused and neglected children were at elevated risk of major depressive disorder (MDD) and psychiatric comorbidity, compared with matched control subjects, when followed up into young adulthood.

Design Prospective cohort design study.

Setting Midwestern metropolitan county area.

Participants Children with substantiated cases of physical and sexual abuse and neglect (before the age of 11 years) from January 1, 1967, to December 31, 1971 (n = 676) were matched based on age, race, sex, and approximate family social class with a group of nonabused and nonneglected children (n = 520) and followed up into young adulthood (mean age, 28.7 years).

Main Outcomes Measures Between October 20, 1989, and December 22, 1995, 2-hour in-person interviews were conducted, using the National Institute of Mental Health Diagnostic Interview Schedule, Version III Revised, to determine DSM-III-R MDD and other psychiatric diagnoses.

Results Child abuse and neglect were associated with an increased risk for current MDD (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.06-2.14; P.05) in young adulthood. Children who were physically abused (OR, 1.59; 95% CI, 1.00-2.52; P.05) or experienced multiple types of abuse (OR, 1.75; 95% CI, 1.01-3.02; P.05) were at increased risk of lifetime MDD, whereas neglect increased risk for current MDD (OR, 1.59; 95% CI, 1.10-2.29; P<.01). Childhood sexual abuse was not associated with elevated risk of MDD. Kaplan-Meier age-of-onset curves (log-rank statistic, 4.03; df = 1; P=.04) showed earlier onset of MDD for abused and neglected children compared with controls. Among those with MDD, comorbidity was higher for abused and neglected individuals than for controls.

Conclusion These results support the need for clinicians to increase efforts to detect and treat depression in physically abused and neglected children.

Author Affiliations: Department of Psychiatry, New Jersey Medical School, University of Medicine & Dentistry of New Jersey, Newark (Drs Widom and Czaja); and Bureau of Evaluation and Research, Office of Children and Family Services, Rensselaer, NY (Dr DuMont).


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