Maltreated neglected children are more likely be troubled adultsBMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8216 (Published 04 December 2012) Cite this as: BMJ 2012;345:e8216
A meta-analysis of 124 observational studies has found a strong and consistent association between non-sexual maltreatment of children and mental health problems, drug use, risky sexual behaviour, and sexually transmitted infections later in life.
The authors focused on physical abuse, emotional abuse, and neglect of children. All three were significantly associated with poor mental health later, including depression, anxiety, eating disorders, and suicide. Risks were increased twofold to threefold in adults who reported abuse as children, relative to those who did not. Most of the studies were cross sectional or retrospective, but 16 prospective cohorts were able to establish that adverse outcomes followed abuse, rather than the reverse.
Many studies made some attempt to control for the confounding effect of social and demographic factors and a shared family environment, but few were able to account for inheritance of poor mental health. Methods, definitions, and populations were heterogeneous, and the authors found hints of publication bias—the tendency for studies reporting positive associations to be published, while negative studies are not.
Despite these limitations, combined results give a strong signal that non-sexual abuse of children is at least an important risk factor for poor mental and sexual health in adulthood, say the authors. Causality is impossible to prove but looks plausible.
Cite this as: BMJ 2012;345:e8216