期刊
JOURNAL OF PSYCHOSOMATIC RESEARCH
卷 137, 期 -, 页码 -出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jpsychores.2020.110207
关键词
Bipolar disorder; Depression; Multimorbidity; Multiple chronic conditions; Child abuse
类别
资金
- National Institute of Mental Health and Johns Hopkins Bloomberg School of Public Health [T32MH014592]
- Intramural Research Program at the National Institute of Mental Health (ZIA) [MH002953]
- Brown Community Health Scholarship at the Johns Hopkins Bloomberg School of Public Health
- Johns Hopkins (NIMH) [T32-MH019545-25S1]
- Intellectual Developmental Disabilities Research Center at Kennedy Krieger [U54 HD079123]
- Intramural Research Program at the National Institute of Mental Health
- National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- NATIONAL INSTITUTE OF MENTAL HEALTH [ZIAMH002953] Funding Source: NIH RePORTER
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.
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