TY - JOUR
T1 - Mood disorders, childhood maltreatment, and medical morbidity in US adults
T2 - An observational study
AU - Stapp, Emma K.
AU - Williams, Stacey C.
AU - Kalb, Luther
AU - Holingue, Calliope B.
AU - Van Eck, Kathryn
AU - Ballard, Elizabeth D.
AU - Merikangas, Kathleen R.
AU - Gallo, Joseph J.
N1 - Funding Information:
EKS received support as a doctoral student from the Psychiatric Epidemiology Training Program funded by the National Institute of Mental Health and Johns Hopkins Bloomberg School of Public Health ( T32MH014592 ; PI: Zandi, Peter), and currently receives support as a postdoctoral fellow in the Intramural Research Program at the National Institute of Mental Health (ZIA MH002953).
Funding Information:
EKS received support as a doctoral student from the Psychiatric Epidemiology Training Program funded by the National Institute of Mental Health and Johns Hopkins Bloomberg School of Public Health (T32MH014592; PI: Zandi, Peter), and currently receives support as a postdoctoral fellow in the Intramural Research Program at the National Institute of Mental Health (ZIA MH002953).SCW received support from the Brown Community Health Scholarship at the Johns Hopkins Bloomberg School of Public Health. SCW also received funding to support her work as a postdoctoral fellow at Johns Hopkins (NIMH T32-MH019545-25S1).LGK received support from Intellectual Developmental Disabilities Research Center at Kennedy Krieger (U54 HD079123).CBH received support from the National Institute of Mental Health Psychiatric Epidemiology Training Program (5T32MH014592; PI: Zandi, Peter).EDB and KRM received support from the Intramural Research Program at the National Institute of Mental Health.The NESARC was funded and conducted by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The NIAAA was not involved in the present study's design, analyses, interpretation of the data, or reporting. Data are publicly available.
Funding Information:
SCW received support from the Brown Community Health Scholarship at the Johns Hopkins Bloomberg School of Public Health . SCW also received funding to support her work as a postdoctoral fellow at Johns Hopkins ( NIMH T32-MH019545-25S1 ).
Funding Information:
EDB and KRM received support from the Intramural Research Program at the National Institute of Mental Health .
Publisher Copyright:
© 2020
PY - 2020/10
Y1 - 2020/10
N2 - Objective: Mood disorders, child maltreatment, and medical morbidity are associated with enormous public health burden and individual suffering. The effect of mood disorders on medical morbidity, accounting for child maltreatment, has not been studied prospectively in a large, representative sample of community-dwelling US adults. This study tested the effects of mood disorders and child maltreatment on medical morbidity, and variation by subtypes. Methods: Participants were noninstitutionalized US adults in the National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093 wave 1, N = 34,653 wave 2). Mood disorders included lifetime DSM-IV episodes of depression, dysthymia, mania, or hypomania. Child maltreatment was defined as sexual, physical, or emotional abuse, or physical or emotional neglect before age 18. Survey-weighted zero-inflated poisson regression was used to study effects on medical morbidity, a summary score of 11 self-reported medical conditions. Results were adjusted for age, sex, ethnicity/race, income, substance use disorders, smoking, and obesity. Results: Mood disorders and child maltreatment additively associated with medical morbidity at study entry and three years later, with similar magnitude as obesity and smoking. Mania/hypomania (incidence rate ratio [IRR] 1.06, 95% CI 1.01–1.10) and child sexual (IRR 1.08, 95% CI 1.04–1.11) and emotional (IRR 1.05, 95% CI 1.01–1.10) abuse were associated with higher medical morbidity longitudinally. Conclusions: Child maltreatment is common, and its long-range negative effect on medical morbidity underscores the importance of trauma-informed care, and consideration of early life exposures. History of mania/hypomania should be considered in medical practice, and physical health must be emphasized in mental health care.
AB - Objective: Mood disorders, child maltreatment, and medical morbidity are associated with enormous public health burden and individual suffering. The effect of mood disorders on medical morbidity, accounting for child maltreatment, has not been studied prospectively in a large, representative sample of community-dwelling US adults. This study tested the effects of mood disorders and child maltreatment on medical morbidity, and variation by subtypes. Methods: Participants were noninstitutionalized US adults in the National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093 wave 1, N = 34,653 wave 2). Mood disorders included lifetime DSM-IV episodes of depression, dysthymia, mania, or hypomania. Child maltreatment was defined as sexual, physical, or emotional abuse, or physical or emotional neglect before age 18. Survey-weighted zero-inflated poisson regression was used to study effects on medical morbidity, a summary score of 11 self-reported medical conditions. Results were adjusted for age, sex, ethnicity/race, income, substance use disorders, smoking, and obesity. Results: Mood disorders and child maltreatment additively associated with medical morbidity at study entry and three years later, with similar magnitude as obesity and smoking. Mania/hypomania (incidence rate ratio [IRR] 1.06, 95% CI 1.01–1.10) and child sexual (IRR 1.08, 95% CI 1.04–1.11) and emotional (IRR 1.05, 95% CI 1.01–1.10) abuse were associated with higher medical morbidity longitudinally. Conclusions: Child maltreatment is common, and its long-range negative effect on medical morbidity underscores the importance of trauma-informed care, and consideration of early life exposures. History of mania/hypomania should be considered in medical practice, and physical health must be emphasized in mental health care.
KW - Bipolar disorder
KW - Child abuse
KW - Depression
KW - Multimorbidity
KW - Multiple chronic conditions
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U2 - 10.1016/j.jpsychores.2020.110207
DO - 10.1016/j.jpsychores.2020.110207
M3 - Article
C2 - 32745641
AN - SCOPUS:85088966821
SN - 0022-3999
VL - 137
JO - Journal of Psychosomatic Research
JF - Journal of Psychosomatic Research
M1 - 110207
ER -