abuse or neglect in childhood and depression in adulthood. OBJECTIVE: To determine whether abused and neglected children were at elevated risk of major depressive disorder (MDD) and psychiatric comorbidity, compared with matched control subjects, when followed up into young adulthood. DESIGN: Prospective cohort design study. SETTING: Midwestern metropolitan county area. PARTICIPANTS: Children with substantiated cases of physical and sexual abuse and neglect (before the age of 11 years) from January 1, 1967, to December 31, 1971 (n = 676) were matched based on age, race, sex, and approximate family social class with a group of nonabused and nonneglected children (n = 520) and followed up into young adulthood (mean age, 28.7 years). Main Outcomes Measures Between October 20, 1989, and December 22, 1995, 2-hour in-person interviews were conducted, using the National Institute of Mental Health Diagnostic Interview Schedule, Version III Revised, to determine DSM-III-R MDD and other psychiatric diagnoses. RESULTS: Child abuse and neglect were associated with an increased risk for current MDD (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.06-2.14; P</=.05) in young adulthood. Children who were physically abused (OR, 1.59; 95% CI, 1.00-2.52; P</=.05) or experienced multiple types of abuse (OR, 1.75; 95% CI, 1.01-3.02; P</=.05) were at increased risk of lifetime MDD, whereas neglect increased risk for current MDD (OR, 1.59; 95% CI, 1.10-2.29; P<.01). Childhood sexual abuse was not associated with elevated risk of MDD. Kaplan-Meier age-of-onset curves (log-rank statistic, 4.03; df = 1; P=.04) showed earlier onset of MDD for abused and neglected children compared with controls. Among those with MDD, comorbidity was higher for abused and neglected individuals than for controls. CONCLUSION: These results support the need for clinicians to increase efforts to detect and treat depression in physically abused and neglected children.
Language: en