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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

Authors

  • Brian Draper MD,

    1. From the *School of Psychiatry, University of New South Wales, Sydney, New South Wales, AustraliaWestern Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, AustraliaSchool of Population Health, University of Melbourne, Melbourne, Australia§Department of Psychological Medicine, University of Sydney, Sydney, AustraliaSchool of Medicine, University of Western Sydney, Sydney, Australia.
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  • Jon J. Pfaff PhD,

    1. From the *School of Psychiatry, University of New South Wales, Sydney, New South Wales, AustraliaWestern Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, AustraliaSchool of Population Health, University of Melbourne, Melbourne, Australia§Department of Psychological Medicine, University of Sydney, Sydney, AustraliaSchool of Medicine, University of Western Sydney, Sydney, Australia.
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  • Jane Pirkis PhD,

    1. From the *School of Psychiatry, University of New South Wales, Sydney, New South Wales, AustraliaWestern Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, AustraliaSchool of Population Health, University of Melbourne, Melbourne, Australia§Department of Psychological Medicine, University of Sydney, Sydney, AustraliaSchool of Medicine, University of Western Sydney, Sydney, Australia.
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  • John Snowdon MD,

    1. From the *School of Psychiatry, University of New South Wales, Sydney, New South Wales, AustraliaWestern Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, AustraliaSchool of Population Health, University of Melbourne, Melbourne, Australia§Department of Psychological Medicine, University of Sydney, Sydney, AustraliaSchool of Medicine, University of Western Sydney, Sydney, Australia.
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  • Nicola T. Lautenschlager MD,

    1. From the *School of Psychiatry, University of New South Wales, Sydney, New South Wales, AustraliaWestern Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, AustraliaSchool of Population Health, University of Melbourne, Melbourne, Australia§Department of Psychological Medicine, University of Sydney, Sydney, AustraliaSchool of Medicine, University of Western Sydney, Sydney, Australia.
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  • Ian Wilson PhD,

    1. From the *School of Psychiatry, University of New South Wales, Sydney, New South Wales, AustraliaWestern Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, AustraliaSchool of Population Health, University of Melbourne, Melbourne, Australia§Department of Psychological Medicine, University of Sydney, Sydney, AustraliaSchool of Medicine, University of Western Sydney, Sydney, Australia.
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  • Osvaldo P. Almeida MD, PhD,

    1. From the *School of Psychiatry, University of New South Wales, Sydney, New South Wales, AustraliaWestern Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, AustraliaSchool of Population Health, University of Melbourne, Melbourne, Australia§Department of Psychological Medicine, University of Sydney, Sydney, AustraliaSchool of Medicine, University of Western Sydney, Sydney, Australia.
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  • for the Depression and Early Prevention of Suicide in General Practice Study Group

    1. From the *School of Psychiatry, University of New South Wales, Sydney, New South Wales, AustraliaWestern Australia Centre for Health and Ageing, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, AustraliaSchool of Population Health, University of Melbourne, Melbourne, Australia§Department of Psychological Medicine, University of Sydney, Sydney, AustraliaSchool of Medicine, University of Western Sydney, Sydney, Australia.
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Address correspondence to Dr. Brian Draper, Academic Department for Old Age Psychiatry, Euroa Centre–Prince of Wales Hospital, Randwick, New South Wales 2031, Australia. E-mail: b.draper@unsw.edu.au

Abstract

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)=1.35, 95% confidence interval (CI)=1.21–1.50) and mental (OR=1.89, 95% CI=1.63–2.19) health, after adjustments. Older adults who reported both childhood sexual and physical abuse also had a higher risk of poor physical (OR=1.60, 95% CI=1.33–1.92) and mental (OR=2.40, 95% CI=1.97–2.94) 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.

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