The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders
Date
2020
Journal Title
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Publisher
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 andmore
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 hypothalamicpituitary-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.
Description
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Keywords
child abuse, long term effects, review, mental health outcomes, health effects
Citation
Lippard, E. T., & Nemeroff, C. B. (2020). The devastating clinical consequences of child abuse and neglect: increased disease vulnerability and poor treatment response in mood disorders. American journal of psychiatry, 177(1), 20-36.