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)=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.