Most evidence on associations between child maltreatment and subsequent common mental disorders (CMDs) comes from retrospective studies. Such findings may be affected by recall bias. Prospective studies of reports to statutory agencies are less common and may be subject to attrition bias.

To examine the associations of child maltreatment with emergency department presentations and in-patient admissions for CMDs in individuals up to 40 years old.

Queensland-wide administrative health data were linked to a prospective birth cohort, including agency-reported and substantiated notifications of child maltreatment. Outcomes were emergency department presentations and in-patient admissions for CMDs.

There were 6087 participants, of which 10.1% had been the subject of a child maltreatment notification. Admissions for CMDs occurred in 198 participants (3.3%) and emergency department presentations in 291 (4.8%). In the adjusted analysis, substantiated child maltreatment was associated with both admissions (odds ratio 1.92; 95% CI = 1.19–3.00) and emergency department presentations (odds ratio 2.10; 95% CI = 1.45–3.03). All agency-reported and substantiated child maltreatment subtypes (neglect, physical, sexual and emotional abuse) were associated with emergency department presentations for CMDs and notifications for more than one child maltreatment subtype. In the subgroup analysis, child maltreatment was associated with emergency department presentations for both anxiety (odds ratio 2.73; 95% CI = 1.68–4.43) and depression (odds ratio 2.23; 95% CI = 1.62–3.26) but with admissions only for depression (odds ratio 2.10; 95% CI = 1.15–3.84).

Child maltreatment is associated with both emergency department presentations and hospital admissions for CMDs in individuals up to 40 years old. Screening for child maltreatment in people presenting to hospital with CMDs may be indicated, as well as a greater awareness that survivors of child maltreatment may be at higher risk of developing such symptoms.

Child maltreatment is a major public health issue worldwide. Retrospective studies show a strong association between self-reported child maltreatment and poor mental and physical health problems. Prospective studies that use reports to statutory agencies are less common, and comparisons of self- and agency-reported abuse in the same cohort even rarer.

This project will link state-wide administrative health data with prospective birth cohort data (N = 7223) from Brisbane in Queensland, Australia (including notifications to child protection agencies), to compare psychiatric outcomes in adulthood of agency- and self-reported child maltreatment while minimising attrition bias.

We will compare people with all forms of self- and agency-reported child maltreatment to the rest of the cohort, adjusting for confounding in logistic, Cox or multiple regression models based on whether outcomes are categorical or continuous. Outcomes will be hospital admissions, emergency department presentations or community/out-patient contacts for ICD-10 psychiatric diagnoses, suicidal ideation and self-harm as recorded in the relevant administrative databases.

This study will track the life course outcomes of adults after having experienced child maltreatment, and so provide an evidence-based understanding of the long-term health and behavioural consequences of child maltreatment. It will also consider health outcomes that are particularly relevant for adolescents and young adults, especially in relation to prospective notifications to statutory agencies. Additionally, it will identify the overlap and differences in outcome for two different sources of child maltreatment identification in the same cohort.

Retrospective studies have shown a high association between child abuse and subsequent psychiatric morbidity. Prospective studies are rarer.

To examine, using a prospective record-linkage analysis, whether substantiated child maltreatment is associated with adverse psychological outcomes in early adulthood.

The participants were 3778 mother and child pairs enrolled in a population-based birth cohort study in Brisbane, Australia. Exposure to suspected child maltreatment was measured by linkage with state child protection agency data. The primary outcomes were the internalising and externalising scales of the Youth Self-Report and the Centre for Epidemiological Studies-Depression scales (CES-D) at approximately 21 years of age. A subset completed the Composite International Diagnostic Interview-Auto version (CIDI-Auto).

In total, 171 (4.5%) participants had a history of substantiated child maltreatment, most commonly emotional abuse (n = 91), followed by physical abuse (n = 78), neglect (n = 73) and sexual abuse (n = 54). After adjustment for potential confounders, depressive symptoms on the CES-D, as well as internalising and externalising behaviours were strongly associated with substantiated abuse in all forms, except sexual abuse. The results for the subset of the sample who completed the CIDI-Auto were less clear. Anxiety, especially post-traumatic stress disorder, showed the strongest association whereas the findings for depressive disorder were equivocal. However, across all diagnostic categories, emotional abuse and neglect, as well as multiple forms of abuse, showed a consistent association.

Child maltreatment, particularly neglect and emotional abuse, has serious adverse effects on early adult mental health. These two warrant the attention given to other forms of child maltreatment. Children experiencing more than one type of maltreatment are at particular risk.

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