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Analysis focuses on causal effects while accounting for other environmental and genetic factors, such as a family history and socioeconomic disadvantages.
Abuse or neglect in childhood can cause multiple mental health issues, according to the results of a study published in American Journal of Psychiatry.
Investigators from the University College London aimed to examine the causal effects of childhood maltreatment and mental health while accounting for other environmental and genetic factors, including a family history of mental illness and socioeconomic disadvantage.
“This study provides rigorous evidence to suggest that childhood maltreatment has small causal effects on mental health problems. Although small, these effects of maltreatment could have far-reaching consequences, given that mental health problems predict a range of poor outcomes, such as unemployment, physical health problems and early mortality,” Jessie Baldwin, PhD, Sir Henry Wellcome Fellow at the University College of London, said in a statement.
“Interventions that prevent maltreatment are therefore not only essential for child welfare but could also prevent long-term suffering and financial costs due to mental illness,” she said.
The study contained an analysis of 34 quasi-experimental studies, including more than 54,000 individuals. A quasi-experimental study can help established cause and effect in observational data, using specialized samples or innovative statistical techniques that are used to rule out other factors.
Across the 34 studies, investigators found small effects of child maltreatment on a range of mental health issues, including attention deficit/hyperactivity disorder; conduct problems; internalized disorders, such as anxiety, depression, self-harm, and suicide attempt; externalized disorders, including alcohol and drug abuse; and psychosis.
Investigators reported that the effects were consistent, regardless of the method they used or the way they measured maltreatment and mental health. The results suggested that preventing 8 cases of child maltreatment would prevent 1 individual from developing mental health issues.
Additionally, investigators found that part of the overall risk of mental health issues in individuals who were exposed to maltreatment was to the result of pre-existing vulnerabilities, which could include adverse environments, such as a socioeconomic disadvantage, and genetic liability.
“Our findings also suggest that to minimize risk of mental health problems in individuals exposed to maltreatment, [physicians] should address not only the maltreatment experience but also pre-existing psychiatric risk factors,” Baldwin said.
Childhood maltreatment was defined as any emotional, physical, or sexual abuse or neglect before aged 18 years.
Study limitations include potential biases from each of the quasi-experimental studies. However, the results were consistent across all studies using different methods, which suggests that the findings are robust.
Additionally, firm conclusions could not be drawn about specific effects of the types of maltreatment, because different types of abuse and neglect can coincide. The studies rarely accounted for that possibility.
A lack of available data mean that it was not possible to examine the differences between ethnic and racial groups, the effects of the timing of maltreatment, or the interval between maltreatment and mental health issues.
Investigators called for conducting future quasi-experimental research to help address some of these unanswered questions to benefit patients.
Reference
Childhood maltreatment linked with multiple mental health problems. EurekAlert. News release. January 11, 2023. Accessed January 11, 2023. https://www.eurekalert.org/news-releases/976042