People who were abused and neglected during childhood have a higher risk of major depression when they become young adults, according to a report in the January issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.
Child abuse has been linked to depression in clinical populations and community surveys, according to background information in the article. But few prospective longitudinal studies have examined the relationship between abuse or neglect in childhood and depression in adulthood.
Cathy Spatz Widom, Ph.D., then of the New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, and now of John Jay College of Criminal Justice, New York, and colleagues conducted a prospective study to determine whether abused and neglected children were at elevated risk of major depressive disorder (MDD) and psychiatric illness, compared with matched control subjects, when followed up into young adulthood. The study included 676 children with substantiated cases of physical and sexual abuse and neglect before the age of 11. They were matched based on age, race, sex, and approximate family social class with 520 non-abused and non-neglected children. All were followed up into young adulthood (average age: 28.7).
"The current results show that childhood physical abuse was associated with increased risk for lifetime MDD," the authors write. "We also provide new evidence that neglected children are at increased risk for depression as well."
Child abuse and neglect were associated with a 51 percent increased risk for current MDD in young adulthood. Children who were physically abused had a 59 percent increased risk of lifetime MDD. Those who experienced multiple types of abuse had a 75 percent increased risk of lifetime MDD. The risk of current MDD was 59 percent higher for those who were neglected.
Childhood sexual abuse was not associated with an elevated risk of MDD. "However, childhood victims of sexual abuse reported significantly more depression symptoms than controls," the authors point out.
"In addition, these findings reveal that onset of depression began in childhood for many of the children," they write. "Our age-at-onset findings reinforce the need to intervene early in the lives of these abused and neglected children, before depression symptoms cascade into other spheres of functioning."
(Arch Gen Psychiatry. 2007;64:49-56. Available pre-embargo to the media at www.jamamedia.org.)
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