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The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment

Elizabeth T C Lippard1, Charles B Nemeroff1

  • 1Department of Psychiatry, Institute of Early Life Adversity Research, and Mulva Clinic for Neuroscience, Dell Medical School, University of Texas, Austin (Lippard, Nemeroff); Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin (Lippard, Nemeroff); and Department of Psychology, University of Texas, Austin (Lippard).

The American Journal of Psychiatry
|August 1, 2023
PubMed

Insights

Childhood maltreatment significantly increases the risk for mood disorders, leading to more severe illness and suicidal behaviors. Understanding these effects on the brain and body can improve treatment and prevention strategies.

Area of Science:

  • Psychiatry
  • Neuroscience
  • Developmental Psychology

Background:

  • Childhood maltreatment has long-lasting adverse effects on physical and mental health.
  • It is a significant risk factor for developing psychiatric and medical disorders.

Purpose of the Study:

  • To review the literature on childhood maltreatment's impact on mood disorder vulnerability.
  • To summarize evidence on mood disorders, including prevalence, risk, comorbidities, and suicidal behaviors.

Main Methods:

  • Review of cross-sectional and longitudinal studies on childhood maltreatment and mood disorders.
  • Examination of persistent biological alterations, including the hypothalamic-pituitary-adrenal axis and inflammatory cytokines.
  • Discussion of genetic and environmental factors influencing disease vulnerability and course.

Main Results:

  • Childhood maltreatment is more prevalent in individuals with mood disorders.
  • It is associated with an increased risk of first mood episodes, recurrence, comorbidities, and suicidal ideation/attempts.
  • Persistent alterations in neurobiological pathways, such as the hypothalamic-pituitary-adrenal axis and inflammatory cytokines, are linked to maltreatment and may drive disease vulnerability.

Conclusions:

  • Childhood maltreatment contributes to increased vulnerability and a more severe course of mood disorders.
  • Neurobiological alterations and genetic/environmental factors mediate these effects.
  • Identifying modifiable mechanisms is crucial for improving treatment and prevention strategies for mood disorders.

Keywords:
Bipolar DisorderDepressionMaltreatmentPosttraumatic Stress

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