Maltreatment in childhood linked to adult depression, heart disease

A history of neglect or abuse in childhood appears to be associated with depression and inflammation in adulthood, a combination that may increase cardiovascular risk, according to a report in the April issue of Archives of General Psychiatry.

"Major depression is a multisystemic disorder that affects both brain and bodily functions," the authors write as background information in the article. Depression and cardiovascular disease often occur simultaneously, and inflammation, a chronic activation of the immune system, has been linked to both. "However, not all individuals with depression have elevated levels of inflammation. Those who do could be at highest risk for cardiovascular disease."

Andrea Danese, MD, MSc, of King's College London, and colleagues studied 1,000 New Zealand residents born between 1972 and 1973. Assessments were carried out every two years between ages 3 and 15, then again at ages 18, 21, 26 and 32. Childhood maltreatment - including rejection by a child's mother, harsh discipline, physical or sexual abuse or disruptive changes in caregivers - was identified through parental reports during childhood years, objective observations of behavior and participants' own reports once they reached adulthood. At age 32, participants underwent physical examinations as well as clinical interviews to diagnose depression.

Individuals with current depression and a history of childhood maltreatment were more likely to have a high level of inflammation at age 32, as measured by the presence of the chemical high-sensitivity C-reactive protein in the blood. Those with depression but no history of childhood maltreatment did not have this increased risk. "The elevated inflammation levels in individuals who were both depressed and maltreated were not explained by correlated risk factors such as depression recurrence, low socioeconomic status in childhood or adulthood, poor health or smoking," the authors write.

"Information about experiences of childhood maltreatment may help to identify depressed individuals with elevated inflammation levels and, thus, greater risk of cardiovascular disease," the authors conclude. "In turn, the early recognition of the health risk associated with maltreatment history might help to address pressing needs for the care of depressed individuals such as the reduction of the effect of depression on comorbid [co-occurring] medical illness."

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Danese A, Moffitt TE, Pariante CM, et al. Elevated Inflammation Levels in Depressed Adults With a History of Childhood Maltreatment. Arch Gen Psychiatry. 2008 Apr;65(4):409-415.   [Abstract]