The Association Between Five Forms of Child Maltreatment and Depressive and Anxiety Disorders: A Systematic Review and Meta-analysis

Background: Child maltreatment is a global public health issue that encompasses physical abuse, sexual abuse, emotional abuse, neglect, and exposure to intimate partner violence (IPV). This systematic review and meta-analysis summarises the association between these five forms of child maltreatment and depressive and anxiety disorders.

Methods: Published cohort and case-control studies were included if they reported associations between any form of child maltreatment (and/or a combination of), and depressive and anxiety disorders. A total of 604 studies were assessed for eligibility, 106 met inclusion criteria, and 96 were included in meta-analyses. The data were pooled in random effects meta-analyses, giving odds ratios (ORs) with corresponding 95% confidence intervals (CIs) for each form of child maltreatment.

Results: All forms of child maltreatment were associated with depressive disorders (any child maltreatment [OR = 2.48, 2.14-2.87]; sexual abuse [OR = 2.11, 1.83-2.44]; physical abuse [OR = 1.78, 1.57-2.01]; emotional abuse [OR = 2.35, 1.74-3.18]; neglect [OR = 1.65, 1.35-2.02]; and exposure to IPV [OR = 1.68, 1.34-2.10]). Several forms of child maltreatment were significantly associated with anxiety disorders ('any child maltreatment' [OR = 1.68, 1.33-2.4]; sexual abuse [OR = 1.90, 1.6-2.25]; physical abuse [OR = 1.56, 1.39-1.76]; and neglect [OR = 1.34, 1.09-1.65]). Significant associations were also found between several forms of child maltreatment and post-traumatic stress disorder (PTSD).

Conclusions: There is a robust association between five forms of child maltreatment and the development of mental disorders. The Global Burden of Disease Study (GBD) includes only sexual abuse as a risk factor for depressive and anxiety disorders. These findings support the inclusion of additional forms of child maltreatment as risk factors in GBD.