Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys

Background Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims To examine joint associations of 12 childhood adversities with first onset of 20 DSM-IV disorders in World Mental Health (WMH) Surveys in 21 countries. Method Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM-IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Results Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Conclusions Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

Bristol-Myers Squibb

Eli Lilly Company

GlaxoSmithKline

Johnson & Johnson Pharmaceuticals

Ortho-McNeil Pharmaceuticals

Pfizer

Sanofi-Aventis

United States National Institute of Mental Health (NIMH/NIH)[R01MH070884]

United States National Institute of Mental Health (NIMH/NIH)[R01-MH059575]

United States National Institute of Mental Health (NIMH/NIH)[RO1-MH61905]

John D. and Catherine T. MacArthur Foundation

Pfizer Foundation

US Public Health Service[R13-MH066849]

US Public Health Service[R01-MH069864]

US Public Health Service[R01 DA016558]

Fogarty International Center (FIRCA/NIH)[FIRCA R03-TW006481]

Pan American Health Organization (PAHO)

Eli Lilly & Company Foundation

Shire

State of Sao Paulo Research Foundation (FAPESP)[03/00204-3]

Ministry of Health

National Center for Public Health Protection

Shenzhen Bureau of Health

Shenzhen Bureau of Science, Technology, and Information

Ministry of Social Protection

European Commission[QLG5-1999-01042]

European Commission[SANCO 2004123]

Piedmont Region (Italy)

Fondo de Investigacion Sanitaria

Instituto de Salad Carlos III, Spain[FIS 00/0028]

Ministerio de Ciencia y Tecnologia, Spain[SAF 2000-158-CE]

Departament de Salut

Generalitat de Catalunya, Spain

Instituto de Salud Carlos III[CIBER CB06/02/0046]

Instituto de Salud Carlos III[RETICS RD06/0011 REM-TAP]

WHO (India)

Japanese and European Funds through United Nations Development Group Iraq Trust Fund (UNDG ITF)

Israel National Institute for Health Policy and Health Services Research

National Insurance Institute of Israel

Japan Ministry of Health, Labour and Welfare[H13-SHOGAI-023]

Japan Ministry of Health, Labour and Welfare[H14-TOKUBETSU-026]

Japan Ministry of Health, Labour and Welfare[H16-KOKORO-013]

Lebanese Ministry of Public Health

WHO (Lebanon)

Fogarty International (FIRCA/NIH)

Act for Lebanon

Janssen Cilag

Eli Lilly

Roche

Novartis

National Institute of Psychiatry Ramon de la Fuente[INPRFMDIES 4280]

National Council on Science and Technology[CONACyT-G30544- H]

New Zealand Ministry of Health

Alcohol Advisory Council

Health Research Council

WHO (Geneva)

WHO (Nigeria)

Federal Ministry of Health, Abuja, Nigeria

Ministry of Public Health

National Institute of Drug Abuse (NIDA/NIH)

South African Department of Health

University of Michigan

National Institute of Mental Health (NIH)[U01-MH60220]

Robert Wood Johnson Foundation (RWJF)[044708]