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Child abuse and mental disorders in Canada
Tracie O Afifi1, Harriet L MacMillan2, Michael Boyle2
1Departments of Community Health Sciences (Afifi, Sareen), Psychiatry (Afifi, Sareen), Family Social Sciences (Afifi), Applied Health Sciences (Taillieu), Psychology (Cheung, Sareen). University of Manitoba, Winnipeg, Man.; Department of Psychiatry and Behavioural Neurosciences (MacMillan, Boyle), Department of Pediatrics (MacMillan), McMaster University, Hamilton, Ont. tracie.afifi@med.umanitoba.ca.
Background:
Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts.
Methods:
We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23,395). The survey had a multistage stratified cluster design (household response rate 79.8%).
Results:
The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose-response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men.
Interpretation:
We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts.
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