Exposure to childhood maltreatment may be associated with a significantly higher risk of developing rheumatoid arthritis and psoriasis later in life, according to a retrospective cohort study.
Published in Heliyon, the research was conducted using UK primary care data and matched 256,130 individuals with a history of childhood maltreatment to 712,478 unexposed individuals on the basis of age, sex, and general practice. Investigators evaluated the development of six immune-mediated inflammatory disorders (IMIDs) over a follow-up period spanning January 1, 1995, to January 31, 2021.
Key findings revealed that the individuals who were exposed to childhood maltreatment were 39% more likely to develop rheumatoid arthritis (RA) (adjusted hazard ratio [HR] = 1.39, 95% confidence interval [CI] = 1.12–1.74) and 16% more likely to develop psoriasis (adjusted HR = 1.16, 95% CI = 1.10–1.23)
The study also reported that maltreatment survivors had no statistically significant increased risk of developing inflammatory bowel disease (IBD) (adjusted HR = 0.87, 95% CI = 0.75–1.00) and a reduced risk of celiac disease (adjusted HR = 0.74, 95% CI = 0.62–0.88).
“Childhood maltreatment is estimated to affect one in three children globally; therefore, an increased risk of developing [RA] and psoriasis represents a substantial contribution to the burden of IMIDs,” the study authors wrote.
The study highlighted the critical need for early intervention and public health strategies to mitigate the downstream effects of childhood maltreatment.
This study utilized a retrospective matched cohort design. Clinical codes from primary care records were used to identify patients exposed to childhood maltreatment, which included physical, sexual, and emotional abuse as well as neglect. Cox regression analysis was applied to evaluate the risk of IMIDs in the exposed vs unexposed groups.
The conditions examined included RA, psoriasis, IBD, celiac disease, multiple sclerosis, and systemic lupus erythematosus.
While increased risks were observed for RA and psoriasis, the study found no significant associations between childhood maltreatment and the development of multiple sclerosis (adjusted HR = 1.07, 95% CI = 0.77–1.49) or lupus (adjusted HR = 1.28, 95% CI = 0.89–1.85).
The increased risk of developing RA and psoriasis highlighted the need to address childhood maltreatment as a significant public health concern, according to the investigators.
"A wider public health approach that aims to build resilience in children and the communities of those at risk of maltreatment will help reduce school absences, relieve youth justice systems, and improve the integration of children in education, training, and employment," emphasized lead study author Liam Snook.
The investigators noted the limitations of their analysis, including potential underreporting of childhood maltreatment and reliance on clinical codes for diagnosis. However, the study offered robust evidence supporting a link between early-life trauma and certain IMIDs.
The findings underscored the importance of preventing and addressing childhood maltreatment as a strategy to reduce the long-term burden of IMIDs. Future research should investigate potential mechanisms linking early-life adversity to immune dysfunction and explore targeted interventions for those at risk.
No potential conflict of interest was mentioned in the study.
