Early life stress associated with major disease burden
One in four children will suffer from trauma caused by abuse or neglect. A new study published in the American Journal of Psychiatry shows that childhood maltreatment can have long-lasting consequences on both mental and physical health.
It may not be too surprising that childhood trauma is associated with a marked increase in risk for psychiatric disorders in later life, however, the results also demonstrate just how important this risk factor is for both mental health and for physical diseases such as diabetes, heart disease, stroke and cancer. The authors call this, "the 'single biggest contributor' to medical and mental illness". Dr Strakowski says that it is hard to exaggerate the level of this form of risk.
Dr Stephen M. Strakowski from the Dell Medical School at the University of Texas at Austin says, "It sounds like an epidemic. If we imagined a new virus suddenly affecting 1 in 4 kids, I assume that people would be quite upset and doing something about it."
Following a review of the studies and literature relating to the impact of adverse childhood experiences, the authors report that the results demonstrate that childhood maltreatment is more prevalent than generally believed. Maltreatment is also associated with increased risk for influencing the following:
- first mood episode,
- episode recurrence,
- greater comorbidities, and
- increased risk for suicidal ideation and attempts in individuals with mood disorders.
They describe both increased risk for onset, but also increased risk for disease recurrence.In other words, this means more mood symptoms occurring over time with increasing severity.
A more pernicious disease course
The report looks at the changes associated with childhood maltreatment, including alterations in the hypothalamic-pituitary-adrenal axis, which influences the inflammatory cytokines. It states that these changes may, "contribute to disease vulnerability and a more pernicious disease course". With regard to genetic influences, several candidate genes and environmental factors are discussed. Fortunately, having identified the single biggest risk factor for mental and physical health the authors also provide insight into treatment mechanisms and prevention strategies.
One of the study authors, Dr Elizabeth Lippard says, "If you look at the prevalence of childhood maltreatment, early life stress, and mood disorders, you see rates as high as fifty to sixty per cent. If you look at individuals with mood disorders and comorbid addiction, rates are even higher". She goes onto say, "Considering the clinical impact that it's having on disease outcomes, and how prevalent child maltreatment is, this is a large percentage of disease burden that can be directly contributed to early life stress. It points to a very powerful target that we need to be thinking about when treating disease."
For further information and video report from Dell Medical School at the University of Texas , please see The 'Single Biggest Contributor' to Medical and Mental Illness
The ACE Questionnaire is available for assessing the adverse childhood experience (ACE) score.