Long-term effects of childhood abuse on the quality of life and health of older people: results from the depression and early prevention of suicide in general practice project
OBJECTIVES: To determine whether childhood physical and sexual abuse are associated with poor mental and physical health outcomes in older age. DESIGN: Cross-sectional, postal questionnaire survey. SETTING: Medical clinics of 383 general practitioners (GPs) in Australia. PARTICIPANTS: More than 21,000 older adults (aged >=60) currently under the care of GPs participating in the Depression and Early Prevention of Suicide in General Practice (DEPS-GP) Study. Participants were divided into two groups according to whether they acknowledged experiencing childhood physical or sexual abuse. MEASUREMENTS: Main outcome measures targeted participants’ current physical health (Medical Outcomes Study 12-item Short Form Survey, Version 2 and Common Medical Morbidities Inventory) and mental health (Patient Health Questionnaire-9 and Hospital Anxiety and Depression Scale). RESULTS: One thousand four hundred fifty-eight (6.7%) and 1,429 participants (6.5%) reported childhood physical and sexual abuse, respectively. Multivariate models of the associations with childhood abuse indicated that participants who had experienced either childhood sexual or physical abuse had a greater risk of poor physical (odds ratio (OR)51.35, 95% confidence interval (CI)51.21– 1.50) and mental (OR51.89, 95% CI51.63–2.19) health, after adjustments. Older adults who reported both childhood sexual and physical abuse also had a higher risk of poor physical (OR51.60, 95% CI51.33–1.92) and mental (OR52.40, 95% CI51.97–2.94) health. CONCLUSION: The effects of childhood abuse appear to last a lifetime. Further research is required to improve understanding of the pathways that lead to such deleterious outcomes and ways to minimize its late-life effects.