Childhood maltreatment associated with development of serious mental illness

A study by the University of Birmingham has shown that children who have experienced child abuse or neglect are four times more likely to develop serious mental illness such as psychoses, schizophrenia and bipolar disorder.

Researchers studied GP records dating between 1995 and 2018 of 217,758 patients aged under 18 who had experienced, or were suspected to have experienced, childhood maltreatment or related concerns, and then compared them to the records of 423,410 patients who had not.

The study, published today (Sept 26th) in The Lancet Psychiatry, found those patients who were maltreated were more than twice as likely to develop serious mental ill health such as psychoses, schizophrenia and bipolar disorder, or require a prescription to treat mental ill health, compared to those who have no recorded experience of maltreatment. The researchers also found maltreated children were more than twice as likely to develop some form of mental illness, such as depression or anxiety.

Childhood maltreatment, defined as any form of physical, sexual or emotional abuse and neglect, is a global public health and human rights issue affecting more than one in three children aged under 18 (i).

This was the biggest study of its kind to explore the association between abuse or neglect in childhood and the development of mental illness.

The researchers also found a clear under-recording of child maltreatment in GP records, and say potential opportunities to spot child maltreatment or implement management plans for these vulnerable individuals are being missed.

First author Dr Joht Singh Chandan, Academic Clinical Fellow in Public Health at the University of Birmingham's Institute of Applied Health Research, said:

Our findings, along with evidence from other global studies, demonstrates the substantial burden of mental ill health following child abuse or neglect.

Considering the prevalence of maltreatment, it is clear we are not doing enough to prevent and detect this important risk factor for mental ill health.

There is a desperate need to rethink our public health approach to preventing and detecting childhood maltreatment and its associated negative consequences."

Corresponding author Julie Taylor, Professor of Child Protection at the University of Birmingham's School of Nursing, said:

Services aiming to build resilience in survivors of maltreatment have shown great promise in the reduction in the development of mental ill health.

Our study, the first if this size and magnitude to have been conducted in the UK, emphasizes the importance of early intervention in abused or neglected children's lives to prevent adverse outcomes."

Corresponding author Dr Krish Nirantharakumar, also of the University of Birmingham, added:

There is an important public health message to focus, not only on approaches that prevent or detect childhood maltreatment, but also to explore methods of prevention and detection of mental ill health in those who have experienced childhood maltreatment.

Building resilience in children, families, local services and communities of those at risk might be a way of improving mental health outcomes."

Source:
Journal reference:

Chandan, J.S. et al. (2019) The burden of mental ill health associated with childhood maltreatment in the UK, using The Health Improvement Network database: a population-based retrospective cohort study. The Lancet Psychiatry. doi.org/10.1016/S2215-0366(19)30369-4.

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