Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: Systematic review and meta-analysis

Abstract

Objectives: To determine whether depression and anxiety in adulthood are associated with abuse exposure in childhood. Methods: A search of PUBMED, EMBASE and PSYCHINFO databases (2002-2012) was supplemented by hand searches of bibliographies of articles and reviews. We included studies contrasting abuse exposure vs. no-abuse exposure before age 16 years to depression and anxiety after age 16 years. Data on sample and exposure and outcome instruments, covariates and odds ratios (ORs) with the respective 95 % confidence intervals (CI) were extracted. Combined ORs and 95 % CI were calculated using random effects models. Heterogeneity was quantified using the I 2 test. Results: Inclusion criteria were met by 19 studies with 115,579 study participants, for assessing depression (n = 14) and anxiety (n = 13). The combined ORs for depression were 2.04 (95 % CI: 1.65-2.53) for sexual abuse and 1.49 (95 % CI: 1.29-1.72) for physical abuse. The combined ORs for anxiety were 2.52 (95 % CI: 2.12-2.98) for sexual abuse and 1.70 (95 % CI: 1.33-2.18) for physical abuse. Conclusions: High levels of depression, anxiety and distress are reported in adults exposed to childhood sexual and physical abuse. These findings require increased awareness for the potential needs of adults exposed to child abuse and public health interventions to prevent child abuse. © 2013 Swiss School of Public Health.