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Association between childhood adversity and a diagnosis of personality disorder in young adulthood: a cohort study of 107,287 individuals in Stockholm County
Karolinska Inst, Div Social Med, Dept Publ Hlth Sci, Stockholm, Sweden.;Univ Calif Los Angeles, Fielding Sch Publ Hlth, Calif Ctr Populat Res, Dept Community Hlth Sci, Los Angeles, CA 90095 USA..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Karolinska Inst, Div Social Med, Dept Publ Hlth Sci, Stockholm, Sweden..
Karolinska Inst, Div Publ Hlth Epidemiol, Dept Publ Hlth Sci, Stockholm, Sweden.;Stockholm Cty Council, Ctr Epidemiol & Community Med, Stockholm, Sweden..
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2017 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 32, no 8, p. 721-731Article in journal (Refereed) Published
Abstract [en]

Childhood adversity (CA) may increase the risk for later developing of personality disorder (PD). However, less is known about the association between cumulative CA and PD, and the role of childhood psychopathology and school performance. The current study examined the relationship between a range of CAs and a diagnosis of PD in young adulthood, and the roles of childhood psychopathology and school performance in this relationship. All individuals born in Stockholm County 1987-1991 (n = 107,287) constituted our cohort. Seven CAs were measured between birth and age 14: familial death, parental criminality, parental substance abuse and psychiatric morbidity, parental separation and/or single-parent household, household public assistance and residential instability. Individuals were followed from their 18th birthday until they were diagnosed with PD or until end of follow-up (December 31st 2011). Adjusted estimates of risk of PD were calculated as hazard ratios (HR) with 95% confidence intervals (CI). Associations were observed between cumulative CA and PD. During the follow-up 770 individuals (0.7%) were diagnosed with PD. Individuals exposed to 3+ CAs had the highest risks of being diagnosed with PD (HR 3.0, 95% CI 2.4-3.7). Childhood psychopathology and low school grades further increased the risk of PD among individuals exposed to CA. Cumulative CA is strongly associated with a diagnosis of PD in young adulthood. Our findings indicate that special attention should be given in schools and health services to children exposed to adversities to prevent decline in school performance, and to detect vulnerable individuals that may be on negative life-course trajectories.

Place, publisher, year, edition, pages
SPRINGER , 2017. Vol. 32, no 8, p. 721-731
Keywords [en]
Childhood adversity, Personality disorder, Epidemiology, Cohort, Sweden
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-335716DOI: 10.1007/s10654-017-0264-9ISI: 000410179400009PubMedID: 28560537OAI: oai:DiVA.org:uu-335716DiVA, id: diva2:1164252
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareAvailable from: 2017-12-11 Created: 2017-12-11 Last updated: 2017-12-11Bibliographically approved

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