TOPLINE

Adults who experienced maltreatment during childhood had higher risks for multiple chronic physical and mental health conditions and developed such issues earlier than those who did not experience maltreatment.

METHODOLOGY

• Researchers examined electronic hospital records in Hong Kong to assess whether maltreatment in childhood was associated with multimorbidity in adulthood.
• They identified 7137 individuals who experienced maltreatment (abuse or neglect) at ages 0-19 years during 2001-2010 and 25,537 matched individuals without such records. The median age at inclusion was 9 years, and 52% were women.
• Researchers assessed the occurrence of 16 adult diagnostic categories. Multimorbidity was classified as simple (≥ 2 long-term conditions), complex (≥ 3 long-term conditions affecting different body systems), or mental health multimorbidity (≥ 2 long-term mental health conditions).
• Individuals were followed up from the age of 19 years until death or December 2024, with a median follow-up duration of 19 years.

TAKEAWAY

• Maltreatment during childhood was associated with increased risks for simple multimorbidity (1.88-fold), complex multimorbidity (1.96-fold), and mental health multimorbidity (3.62-fold; P < .001 for all), with smaller risks noted in individuals who already had mental or neurodevelopmental issues during childhood.
• Adults maltreated during childhood had a 2.78-fold higher risk for mental and behavioral disorders than those who were not maltreated (P < .001), including anxiety, psychotic disorders, and personality disorders.
• The risk for overall injuries, self-harm, assaults, and accidents was also 1.68- to 3.96-fold higher in adults who were maltreated during childhood than those who were not (P < .001 for all).
• Adults who were maltreated during childhood developed chronic health conditions 7-8 years earlier than those who were not maltreated.

IN PRACTICE

“Our best efforts to improve health outcomes are to think upstream and invest in preventing child maltreatment. To do so, we must reprioritize the health, safety, and human rights of the developing child. In the context of global population aging and associated healthcare pressures, we must recenter our health equity focus on the entire life course, including childhood,” Nicole G. Hammond, PhD, and Tracie O. Afifi, PhD, wrote in an invited commentary.

SOURCE

The study was led by Rosa S. Wong, PhD, and Keith T.S. Tung, PhD, The University of Hong Kong, Hong Kong, China. It was published online on July 14 in JAMA Network Open. The authors of the invited commentary were at the College of Community and Global Health, University of Manitoba, Winnipeg, Manitoba, Canada.

LIMITATIONS

Hospital records might have mostly captured severe cases; thus, the results might not have reflected milder cases. Some socioeconomic and family factors were unmeasured. The records lacked details on the type and severity of maltreatment.

DISCLOSURES

The authors did not report any specific source of funding for the study. One author reported receiving grants from the Health and Medical Research Fund and the General Research Fund. Another author reported receiving grants from multiple sources, including the Wellcome Trust, National Institute for Health and Care Research, and Engineering and Physical Sciences Research Council.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.