The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders
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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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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)
Experimental — accuracy not yet measuredEarly 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).”
From Childhood Trauma, the HPA Axis and Psychiatric Illnesses: A Targeted Literature Synthesis (2022) · cites this paper as [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”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [11]
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Cyberbullying and LGBTQ Youth: A Deadly Combination
Wiederhold, B. K. (2014) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2014.1521 · Cited by 39 · see citing works
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“Various forms of abuse (Lippard and Nemeroff, 2020) and other common histories for people with mental health problems (Van der Kolk, 2015) indicate that either they did not experience feeling a sense of security or safeness and “loving” empathic engagement with developmental needs being met, and/or as they move throug…”
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“These longlasting consequences may be due to the well-documented association between child abuse and alterations in the brain structure and function and their related poorer treatment responses [6,7].”
BackgroundSelf-Compassion: An Evolutionary, Biopsychosocial, and Social Mentality Approach
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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
- PMC
- PMC6939135
- 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
- bronze
- doi.org
- 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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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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