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Childhood adversities and the comorbidity between mood and general medical disorders in adults
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Objective: Childhood adversities have been linked to poor health outcomes in adults, including both mood and general medical disorders. Here we tested the hypothesis that childhood adversities specifically increase the risk of comorbidity between mood and general medical disorders, rather than increasing the risk of either one independently. Methods: Mood disorders (DSM-IV major depressive, dysthymic and bipolar disorders), childhood adversities and general medical disorders were assessed in 2060 adults in the WHO World Mental Health Survey Portugal. Discrete-time survival analyses were used to investigate the association between mood disorders and subsequent first-onset general medical disorders and between general medical disorders and subsequent first-onset mood disorders, in adults. Discrete-time survival and multinomial regression analyses were used to test the influence of childhood adversities on the comorbidity between mood disorders and general medical disorders. Anxiety disorders were used as a psychiatric control. Results: Adult-onset mood disorders were found to precede the onset of diabetes (OR:1.8; 95% CI:1.2-2.9), arthritis (OR:1.6; 95% CI:1.1-2.3) and seasonal allergies (OR:1.6; 95% CI:1.1-2.5) while adult-onset hypertension was found to precede the onset of mood disorders (OR:1.7; 95% CI:1.2-2.6). Maladaptive family functioning (abuse, neglect and parental maladjustment), was associated with mood disorders (OR:1.5; 95% CI:1.2-1.9), hypertension (OR:1.4; 95% CI:1.1-1.7), arthritis (OR:1.3; 95% CI:1.0-1.6) and seasonal allergies (OR:1.5; 95% CI:1.1-2.0) in adulthood. Finally, the effect of maladaptive family functioning in predicting comorbid mood disorders and arthritis significantly differed from its effect in predicting only arthritis (p = 0.01), which was not observed for other comorbidities. Maladaptive family functioning further predicted comorbid anxiety disorders and hypertension. Conclusion: Childhood adversities may be a specific risk factor for comorbid mood disorders and arthritis in adults.
Descrição
Funding: The WHO World Mental Health Survey Portugal was carried out by the Department of Mental Health, NOVA Medical School, NOVA University of Lisbon, with collaboration of the CESOP–Portuguese Catholic University and was funded by the Champalimaud Foundation, the Gulbenkian Foundation, the Foundation for Science and Technology (FCT) and the Ministry of Health. TheWHO World Mental Health Survey Portugal was carried out in conjunction with the World Health Organization WMH Survey Initiative which is supported by the National Institute of Mental Health (NIMH; R01MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the U.S. Public Health Service (R13-MH066849, R01-MH069864 and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, OrthoMcNeil Pharmaceutical, GlaxoSmithKline and Bristol-Myers Squibb. This study was supported by a NARSAD 2018 Young Investigator Grant (ID: 27,595) awarded to J.O. and a Fundação para a Ciência e Tecnologia (FCT) grant (PTDC/MED-NEU/31,331/2017) and a European Commision Horizon 2020 grant (H2020-SC1-DTH-2018-2020_H2020-SC1-DTH2019-875358-FAITH) awarded to A.J.O.-M. Funding sources had no role in study design, data collection, analysis, interpretation of data, writing of the manuscript and decision to submit the paper for publication.
Palavras-chave
Childhood adversity Mood disorders General medical disorders Arthritis Inflammation SDG 3 - Good Health and Well-being