Childhood physical abuse and respiratory disease in the community: the role of mental health and cigarette smoking.

INTRODUCTION: Previous studies have found an association between child abuse and respiratory disease in some populations, but the mechanisms remain unknown, and this association has not been examined in a representative community-based sample. The goal of this study was to examine the relationship between childhood physical abuse and the odds of respiratory disease and to investigate the role of depression, anxiety, and pack-years of smoking in this association.
METHODS: Data were drawn from the Midlife Development in the United States Survey (n = 3,032), a representative sample of adults aged 25-74 years. Multiple logistic regression analyses were used to determine the association between childhood abuse and current respiratory disease (past 12 months) and to examine whether pack-years of smoking, depression, and anxiety disorders mediated the relationship.
RESULTS: Individuals who often experienced childhood abuse had a significantly increased odds of respiratory disease (odds ratio [OR] = 1.87 [1.21, 2.90]). The association was attenuated, after adjusting for demographic characteristics and pack-years of smoking, and was no longer significant after adjusting for depression and anxiety disorders.
CONCLUSIONS: These results are consistent with previous data suggesting a significant association between childhood abuse and respiratory disease and extend existing knowledge by providing initial evidence that demographic differences, depression and anxiety disorders, and lifetime cigarette smoking may mediate this observed relationship. Results require replication with longitudinal data in large community-based samples. Future studies that can explore potential biological mechanisms underlying the observed associations, such as immune factors, are needed next to better understand these relationships.