The burden of mental ill health associated with childhood maltreatment in the UK, using The Health Improvement Network database: a population-based retrospective cohort study

Chandan, Joht Singh; Thomas, Tom; Gokhale, Krishna; Bandyopadhyay, Siddhartha; Taylor, Julie; Nirantharakumar, Krishnarajah

doi:10.1016/s2215-0366(19)30369-4

Cited by 58 publications

(54 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Childhood maltreatment (trauma/abuse/neglect) is an important environmental factor in the aetiology of mood disorders (Brühl et al, 2019; Buckman et al, 2018). A large cohort study of over 11 million adults in the United Kingdom, for example, found that those who disclosed childhood maltreatment were 2.14 times more likely to have a psychiatric diagnosis – with mood disorders featuring particularly prominently (Chandan et al, 2019). Earlier literature identified an even higher relative risk, with a fourfold increase in risk of depression in women who have survived childhood abuse (Mullen et al, 1996).…”

Section: Aetiology and Pathogenesis Of Mood Disordersmentioning

confidence: 99%

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Malhi

Bell

Bassett³

et al. 2020

Aust N Z J Psychiatry

288

365

View full text Add to dashboard Cite

Objectives: To provide advice and guidance regarding the management of mood disorders, derived from scientific evidence and supplemented by expert clinical consensus to formulate s that maximise clinical utility. Methods: Articles and information sourced from search engines including PubMed, EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (e.g. books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Relevant information was appraised and discussed in detail by members of the mood disorders committee, with a view to formulating and developing consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous consultation and external review involving: expert and clinical advisors, key stakeholders, professional bodies and specialist groups with interest in mood disorders. Results: The Royal Australian and New Zealand College of Psychiatrists mood disorders clinical practice guidelines 2020 (MDcpg2020) provide up-to-date guidance regarding the management of mood disorders that is informed by evidence and clinical experience. The guideline is intended for clinical use by psychiatrists, psychologists, primary care physicians and others with an interest in mental health care. Conclusion: The MDcpg2020 builds on the previous 2015 guidelines and maintains its joint focus on both depressive and bipolar disorders. It provides up-to-date recommendations and guidance within an evidence-based framework, supplemented by expert clinical consensus. Mood disorders committee: Gin S Malhi (Chair), Erica Bell, Darryl Bassett, Philip Boyce, Richard Bryant, Philip Hazell, Malcolm Hopwood, Bill Lyndon, Roger Mulder, Richard Porter, Ajeet B Singh and Greg Murray.

show abstract

Section: Aetiology and Pathogenesis Of Mood Disordersmentioning

confidence: 99%

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Malhi

Bell

Bassett³

et al. 2020

Aust N Z J Psychiatry

288

365

View full text Add to dashboard Cite

show abstract

“…The negative downstream social, psychological and physical health effects of childhood maltreatment and domestic abuse bear a substantial societal cost. [3][4][5][6][7][8][9][10][11][12] Therefore, a public health approach is urgently needed to prevent both the occurrence of childhood maltreatment and domestic abuse as well strengths and limitations of this study ► Primary care data encompass a vast proportion of society, and as current guidance is to ensure identification of domestic abuse and childhood maltreatment by general practitioners, studying the epidemiology within this dataset is important. ► Despite the vast cohort size, our results demonstrate substantial under-recording of childhood maltreatment and domestic abuse.…”

Section: Introductionmentioning

confidence: 99%

Exploration of trends in the incidence and prevalence of childhood maltreatment and domestic abuse recording in UK primary care: a retrospective cohort study using ‘the health improvement network’ database

et al. 2020

Self Cite

View full text Add to dashboard Cite

ObjectivesDescribe the epidemiology of childhood maltreatment and domestic abuse (in women).DesignAnalysis of longitudinal records between 1 January 1995 to 31 December 2018.SettingUK primary care database: ‘The Health Improvement Network’ (THIN).Participants11 831 850 eligible patients from 787 contributing practices. Childhood maltreatment and domestic abuse (women only) were defined as the presence of a recorded Read code.Outcome measuresThe incidence rate (IR) and prevalence of childhood maltreatment (in children aged 0–18 years) and domestic abuse (in women aged over 18) between 1996 and 2017. An adjusted incidence rate ratio (aIRR) is given to examine the differences in IRs based on sex, ethnicity and deprivation.ResultsThe age and gender breakdown of THIN has been previously reported to be representative of the UK population, however, there is substantial missing information on deprivation quintiles (<20%) and ethnicity (approximately 50%). The IR (IR 60.1; 95% CI 54.3 to 66.0 per 100 000 child years) and prevalence (416.1; 95% CI 401.3 to 430.9 per 100 000 child population) of childhood maltreatment rose until 2017. The aIRR was greater in patients from the most deprived backgrounds (aIRR 5.14; 95% CI 4.57 to 5.77 compared with least deprived) and from an ethnic minority community (eg, black aIRR 1.25; 1.04 to 1.49 compared with white). When examining domestic abuse in women, in 2017, the IR was 34.5 (31.4 to 37.7) per 100 000 adult years and prevalence 368.7 (358.7 to 378.7) per 100 000 adult population. Similarly, the IR was highest in the lowest socioeconomic class (aIRR 2.30; 2.71 to 3.30) and in ethnic minorities (South Asian aIRR 2.14; 1.92 to 2.39 and black aIRR 1.64; 1.42 to 1.89).ConclusionDespite recent improvements in recording, there is still a substantial under-recording of maltreatment and abuse within UK primary care records, compared with currently existing sources of childhood maltreatment and domestic abuse data. Approaches must be implemented to improve recording and detection of childhood maltreatment and domestic abuse within medical records.

show abstract

“…As months will have passed since the abuse, there may be little physical evidence to support allegations, in turn reducing the weight of corroborative evidence to support child protection measures and risking children feeling they are not believed. Child abuse carries long-term risks for cumulative physical and mental health problems(16,17), and without intervention a cycle of intergenerational poor parenting and abuse may result(18). There were 30 fewer CPME referrals than expected during 2020: given that Birmingham accounts for 2% of children referred for social care assessment nationally (1) we estimate that there are approximately 1500 (95%CI 538-2192) potentially abused or neglected children in England who remain hidden from services.…”

Section: Discussionmentioning

confidence: 99%

Effect of covid-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK

Garstang

Debelle

Anand

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Objectives To determine any change in referral patterns and outcomes in children (0-18) referred for child protection medical examination (CPME) during the covid-19 pandemic compared to previous years. Design Retrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown. Setting Birmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288,000 children. Participants Children aged under 18 years attending CPME during an 18 week period from late February to late June during the years 2018, 2019, and 2020. Main Outcome Measures Numbers of referrals, source of disclosure and outcomes from CPME Results There were 78 CPME referrals in 2018, 75 in 2019 and 47 in 2020, this was a 39.7% (95%CI 12.4-59.0) reduction in referrals from 2018 to 2020, and a 37.3% (95%CI 8.6-57.4) reduction from 2019 to 2020. There were fewer CPME referrals initiated by school staff in 2020, 12(26%) compared to 36 (47%) and 38 (52%) in 2018 and 2019 respectively. In all years 75.9% of children were known to social care prior to CPME, and 94% of CPME concluded that there were significant safeguarding concerns. Conclusions School closure due to covid-19 may have harmed children as child abuse has remained hidden. There needs to be either mandatory attendance at schools in future or viable alternatives found. There may be a significant increase in safeguarding referrals when schools fully re-open as children disclose the abuse they have experienced at home.

show abstract

The burden of mental ill health associated with childhood maltreatment in the UK, using The Health Improvement Network database: a population-based retrospective cohort study

Cited by 58 publications

References 25 publications

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders

Exploration of trends in the incidence and prevalence of childhood maltreatment and domestic abuse recording in UK primary care: a retrospective cohort study using ‘the health improvement network’ database

Effect of covid-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK

Contact Info

Product

Resources

About