Childhood abuse (CA) has been implicated in a variety of psychiatric disorders. In this study we investigated the prevalence of CA in 590 adult psychiatric patients (344 men, 245 women), who were admitted to a psychiatric emergency room. Patients were grouped into six diagnostic categories, namely, major depressive disorder (MDD) (N = 165), depression not otherwise specified (NOS) (N = 61), bipolar disorder (BD) (N = 138), mood disorder NOS (N = 22), psychotic disorders (N = 159), and ‘Other’ (N = 45). The prevalence of CA in this cohort was 36.71%, which was significantly higher than in the general population as reported by the Center for Disease Control (X² = 102.96, p < 0.001). CA was significantly higher in women than in men in the total cohort (47.44% vs. 28.72%, X² = 18.60, p = 0.00). Gender difference was particularly observed in MDD (45.45% vs. 25.97%, X² = 5.93, p < .01), and was a trend in BD (58.33% vs. 40.74%, X² = 3.52, p < 0.06). CA was significantly higher in patients with family psychiatric history (47.20% vs. 26.88%, X² = 18.59, p = 0.00). This was observed in MDD (44.58% vs. 20.75%, X² = 8.04, p < 0.005), BD (59.49% vs. 28.57%, X² = 7.91, p < 0.005) and psychotic disorders (40.38% vs. 23.94%, X² = 3.80, p < 0.05).
Among patients with a family psychiatric history, CA was significantly higher in women than in men in the total cohort (57.66% vs. 38.85%, X² = 8.76, p < 0.003), specifically in MDD (56.41% vs. 34.09%, X² = 4.17, p < 0.04) and in BD (70.00% vs. 48.72%, X² = 3.71, p < 0.05). Curiously, co-morbidity with substance abuse by itself was not associated with a significantly higher prevalence of CA in the total cohort (X² = 0.571, p = ns). Only patients with psychotic disorders and co-morbid substance abuse had significantly higher prevalence of CA (61.19% vs. 43.54%, X² = 3.80, p < 0.05). In patients with co-morbid substance abuse, CA again was significantly higher in women than in men in the total cohort (52.20% vs. 22.22%, X² = 31.35, p = 0.00), particularly in MDD (48.94% vs. 25.81%, X² = 6.22, p < 0.01), with a trend in BD (60.45% vs. 40.91%, X² = 3.33, p < 0.07). Finally, CA was associated with significantly higher incidence of suicide attempts (42.43% vs. 25.15%, X² = 14.36, p = 0.00), and higher incidence of homosexual orientation (61.90% vs. 36.32%, X² = 5.33, p < 0.02), but was not significantly correlated with academic achievement.
Results of this investigation establish a significant association between CA and mood disorders, and underscore the contribution of CA to the high incidence of depression in women. A positive family psychiatric history is a risk factor for CA, particularly in women. Co-morbid substance abuse was not particularly related to CA and seems to be an epiphenomenon perhaps related to the primary underlying mood disorder.
|Keywords:||Childhood Abuse, Major Depressive Disorder, Bipolar Disorder, Substance Abuse, Sexual Orientation, Family Psychiatric History|
Student, St. Edward’s University, Austin, Texas, USA
Associate Professor, University of Texas Southwestern Medical School, Dallas, Texas, USA
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