Psychiatric co-morbidity in caregivers and children involved in maltreatment: a pilot research study with policy implications

Objective: The purpose of this study was to determine the lifetime incidenc e of mental disorders in caregivers involved in maltreatment and in their m altreated child. Methods: Lifetime DSM-III-R and IV psychiatric diagnoses were obtained for 53 maltreating families, including at least one primary caregiver and one p roband maltreated child or adolescent subject (28 males, 25 females), and f or a comparison group of 46 sociodemographically, similar nonmaltreating fa milies, including one proband healthy child and adolescent subject (22 male s, 22 females). Results: Mothers of maltreated children exhibited a significantly greater l ifetime incidence of anxiety disorders (especially post-traumatic stress di sorder), mood disorders, alcohol and/or substance abuse or dependence disor der, suicide attempts, and comorbidity of two or more psychiatric disorders , compared to control mothers. Natural fathers or mothers' live-in mates in volved in maltreatment exhibited a significantly greater lifetime incidence of an alcohol and/or substance abuse or dependence disorder compared to co ntrols. The majority of maltreated children and adolescents reported anxiet y disorders, especially post-traumatic stress disorder (from witnessing dom estic violence and/or sexual abuse), mood disorders, suicidal ideation and attempts, and disruptive disorders. Most maltreated children (72%) suffered from comorbidity involving both emotional and behavioral regulation disord ers. Conclusions: Families involved in maltreatment manifest significant histori es of psychiatric comorbidity. Policies which target identification and tre atment of comorbidity may contribute to breaking the intergenerational tran smission of maltreatment. (C) 2001 Elsevier Science Ltd. All rights reserve d.