Cited by 527Child Abuse and TraumaChild Welfare and AdoptionChild and Adolescent Psychosocial and Emotional Development

The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders

Open access
Lippard, Elizabeth T.C., Nemeroff, Charles B.·2020·American Journal of Psychiatry

Abstract

A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development can have long-lasting consequences. It is associated with a marked increase in risk for psychiatric and medical disorders. This review summarizes the literature investigating the effects of childhood maltreatment on disease vulnerability for mood disorders, specifically summarizing cross-sectional and more recent longitudinal studies demonstrating that childhood maltreatment is more prevalent and is associated with increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts in individuals with mood disorders. It summarizes the persistent alterations associated with childhood maltreatment, including alterations in the hypothalamic-pituitary-adrenal axis and inflammatory cytokines, which may contribute to disease vulnerability and a more pernicious disease course. The authors discuss several candidate genes and environmental factors (for example, substance use) that may alter disease vulnerability and illness course and neurobiological associations that may mediate these relationships following childhood maltreatment. Studies provide insight into modifiable mechanisms and provide direction to improve both treatment and prevention strategies.

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Crossref · 10.1176/appi.ajp.2019.19010020

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  • Not all individuals who experience life stress develop MDD and/or a physical disease.

    “not all individuals who experience life stress develop MDD and/or a physical disease153,154.”

    From Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management (2023) · cites this paper as [154]

    The Underlying Mechanisms section states that not all individuals who experience childhood maltreatment develop mood disorders, supporting the claim’s point about differing vulnerability to depression. It does not extend that statement to life stress generally or to physical disease. (LLM, conf=0.86)

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  • Early life stress due to childhood abuse and/or neglect has been linked to increased risk of psychiatric illness onset and recurrence, increased disease severity and poor treatment response.

    “Early life stress (ELS) due to childhood abuse and/or neglect has been linked to increased risk of psychiatric illness onset and recurrence, increased disease severity and poor treatment response (pharmacotherapy and psychotherapy) (148, 149).”
  • Recent research on childhood abuse and neglect emphasises the lasting effects on the risks for depression not only in childhood and adolescence, but also later in life and in subsequent generations.

    “Recent research on childhood abuse and neglect, for instance, emphasises the lasting effects on the risks for depression not only in childhood and adolescence, but also later in life and in subsequent generations. 11”

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Research works printed but not linked: 8

  1. [6]Green JG,, Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Arch Gen Psychiatry, 2010 67(2): p. 113– 23. 20124111 PMC2822662
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Authors
Lippard, E. T. C., & Nemeroff, C. B.
Affiliations
The University of Texas at Austin (US)
Venue
American Journal of Psychiatry
Published
2020-01-01
Volume
177
Issue
1
Pages
20-36
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
OpenAlex
W2973818823
Cited by
527
References
230
Citations by year
2026: 60 · 2025: 88 · 2024: 91 · 2023: 96 · 2022: 104 · 2021: 58 · 2020: 25 · 2019: 1
FWCI
7.44
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Brain and Behavior Research Foundation
  • American Foundation for Suicide Prevention
  • American Psychiatric Publishing
  • Celgene
  • Sunovion
  • OPKO Health
  • National Institutes of Health (AA024933)
  • Department of Mechanical Engineering, University of Texas at Austin
  • Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin
  • Dell Medical School, University of Texas at Austin
  • Laureate Institute for Brain Research, University of Tulsa
  • National Institute on Alcohol Abuse and Alcoholism (K01AA027573, R01AA024933)
  • National Institute of Mental Health (R01MH117293)
  • Janssen Research and Development
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Safety Research › Child Welfare and Adoption
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
child abuse, mood disorders, bipolar disorder, depression, disease susceptibility, treatment response, suicidal ideation, suicide attempts, episode recurrence, comorbidities, hypothalamic-pituitary-adrenal axis, inflammatory cytokines, candidate genes, substance use, neurobiology of depression, prevention
MeSH terms
Child, Child Abuse, Disease Susceptibility, Humans, Risk Factors, Comorbidity, Mood Disorders

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