Childhood abuse v. neglect and risk for major psychiatric disorders
Alkema, Anne; Marchi, Mattia; Van Der Zaag, Jeroen A.J.; Van Der Sluis, Daniëlle; Warrier, Varun; Ophoff, Roel A.; Kahn, René S.; Cahn, Wiepke; Hovens, Jacqueline G.F.M.; Riese, Harriëtte; Scheepers, Floortje; Penninx, Brenda W.J.H.; Cecil, Charlotte; Oldehinkel, Albertine J.; Vinkers, Christiaan H.; Boks, Marco P.M.; Genetic Risk and Outcome of Psychosis (GROUP) Investigators
(2024) Psychological medicine, volume 54, pp. 1598 - 1609
(Article)
Abstract
Background Childhood maltreatment (CM) is a strong risk factor for psychiatric disorders but serves in its current definitions as an umbrella for various fundamentally different childhood experiences. As first step toward a more refined analysis of the impact of CM, our objective is to revisit the relation of abuse and
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neglect, major subtypes of CM, with symptoms across disorders. Methods Three longitudinal studies of major depressive disorder (MDD, N = 1240), bipolar disorder (BD, N = 1339), and schizophrenia (SCZ, N = 577), each including controls (N = 881), were analyzed. Multivariate regression models were used to examine the relation between exposure to abuse, neglect, or their combination to the odds for MDD, BD, SCZ, and symptoms across disorders. Bidirectional Mendelian randomization (MR) was used to probe causality, using genetic instruments of abuse and neglect derived from UK Biobank data (N = 143 473). Results Abuse was the stronger risk factor for SCZ (OR 3.51, 95% CI 2.17-5.67) and neglect for BD (OR 2.69, 95% CI 2.09-3.46). Combined CM was related to increased risk exceeding additive effects of abuse and neglect for MDD (RERI = 1.4) and BD (RERI = 1.1). Across disorders, abuse was associated with hallucinations (OR 2.16, 95% CI 1.55-3.01) and suicide attempts (OR 2.16, 95% CI 1.55-3.01) whereas neglect was associated with agitation (OR 1.24, 95% CI 1.02-1.51) and reduced need for sleep (OR 1.64, 95% CI 1.08-2.48). MR analyses were consistent with a bidirectional causal effect of abuse with SCZ (IVWforward = 0.13, 95% CI 0.01-0.24). Conclusions Childhood abuse and neglect are associated with different risks to psychiatric symptoms and disorders. Unraveling the origin of these differences may advance understanding of disease etiology and ultimately facilitate development of improved personalized treatment strategies.
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Keywords: bipolar disorder, child abuse, child neglect, childhood maltreatment, gene-environment correlation, major depressive disorder, risk factor, schizophrenia, trans-diagnostic symptom profiles, Applied Psychology, Psychiatry and Mental health, Journal Article
ISSN: 0033-2917
Publisher: Cambridge University Press
Note: Publisher Copyright: © The Author(s), 2023. Published by Cambridge University Press.
(Peer reviewed)