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Arch Gen Psychiatry. 2007 Jan;64(1):49-56.

A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up.

Author information

1
Department of Psychiatry, New Jersey Medical School, University of Medicine & Dentistry of New Jersey, 183 S. Orange Avenue, Newark, NJ 07103, USA. widomca@umdnj.edu

Abstract

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 non-abused and non-neglected children (n = 520) and followed up into young adulthood (mean age, 28.7 years).

MAIN OUTCOME 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< or=.05) in young adulthood. Children who were physically abused (OR, 1.59; 95% CI, 1.00-2.52; P< or =.05) or experienced multiple types of abuse (OR, 1.75; 95% CI, 1.01-3.02; P< or =.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.

PMID:
17199054
DOI:
10.1001/archpsyc.64.1.49
[Indexed for MEDLINE]

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