Association between child abuse exposure and the risk of psychiatric disorders: A nationwide cohort study in Taiwan.

BACKGROUND

Child abuse affects children physiologically and psychologically, increasing the risk of future psychiatric disorders.

OBJECTIVE

To assess whether child abuse victims have a higher incidence of future psychiatric disorders or substance abuse.

PARTICIPANTS AND

SETTING

The participants consisted of a nationwide, population-based cohort selected in accordance with the Taiwan National Health Insurance Research Database. All children were enrolled between 2000 and 2015.

METHODS

This was a retrospective study with a matched-cohort design. Children who experienced child abuse were identified using International Classification of Disease codes and compared with children who had not experienced child abuse by measuring rates of anxiety disorders, depressive disorders, bipolar disorders, sleep disorders, posttraumatic stress disorder/acute stress disorder, eating disorders, substance-related disorders (alcohol use disorder and illicit drug use disorder), psychotic disorders, and organic mental disorders.

RESULTS

The psychiatric disorder risk was significantly higher in victims of child abuse than in controls (adjusted hazard ratio, 2.15; 95 % confidence interval, 1.92-2.40; P < 0.001). The Kaplan-Meier analysis revealed a significantly higher 15-year cumulative incidence of psychiatric disorders among child abuse victims than among controls (394.57 vs. 317.56 events per 100,000 person-years; log-rank test, P <  0.001).

CONCLUSIONS

In Taiwan, child abuse is associated with increased psychiatric disorder and substance abuse risk. Individuals involved in caring for abused children, including family members, pediatricians, nurses, and social workers, as well as policy makers, should be aware of this risk. Early referral of child abuse victims to pediatric psychiatrists may help detect high-risk cases and facilitate early intervention.