Adult-onset chronic physical conditions are more common in people who report childhood adversities and early onset mental disorders

Question: Are childhood adversities and early-onset (at age <21 years) mental disorders independently associated with increased risk of adult-onset chronic physical conditions? Population: 18 303 adults taking part in the WHO World Mental Health (WMH) Surveys. Participants were selected by a multistage, clustered, area probability household sample. Setting: General population in 10 countries (Colombia, Mexico, the USA, Belgium, France, Germany, Italy, the Netherlands, Spain and Japan); from 1st January 2001 to 31st December 2004. Assessment: All surveys used the WMH version of the WHO Composite International Diagnostic Interview (WMHCIDI) administered by trained lay interviewers who used the WMH Surveys version of the WHO composite International Diagnostic Interview (WMH-CIDI). Diagnoses of mental health disorders were made using DSM-IV criteria. All respondents who met the criteria for any mental health disorder and a probability sample of other respondents then completed the second part of the survey which collected information on the occurrence of childhood adversities occurring within the family (eg, physical abuse, sexual abuse, neglect, parental death, parental divorce, other parental loss, parental mental disorder, parental substance use, parental criminal behaviour, family violence and family economic adversity) and on chronic physical conditions (US Health Interview Schedule). Participants were asked their age when the diagnosis was made or symptoms fi rst appeared, and individuals reporting onset of the physical conditions before age 21 were excluded from the analysis. Outcomes: Chronic physical conditions (heart disease, asthma, diabetes mellitus, arthritis, chronic spinal pain and chronic headache).

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