First Onset in Adulthood of Mental Disorders: Exposure to War vs. Non-war Childhood Adversities: A National Study

Elie Karam; Josleen Al Barathie; Dahlia Saab; Aimee Nasser Karam; John Fayyad

doi:10.2174/0117450179216651231106072824

First Onset in Adulthood of Mental Disorders: Exposure to War vs. Non-war Childhood Adversities: A National Study

Clin Pract Epidemiol Ment Health. 2023 Nov 7:19:e17450179216651. doi: 10.2174/0117450179216651231106072824. eCollection 2023.

Authors

Elie Karam^{1

2

3}, Josleen Al Barathie¹, Dahlia Saab¹, Aimee Nasser Karam^{1

2

3}, John Fayyad^{1

2

3}

Affiliations

¹ Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon.
² Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon.
³ Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon.

PMID: 38655552
PMCID: PMC11037514
DOI: 10.2174/0117450179216651231106072824

Abstract

Background: There is evidence that some childhood trauma increases the risk of the first onset of mental disorders and for the first time into adulthood. There are no studies that assessed whether exposure to war has this delayed long-term effect.

Objectives: To fill this gap by investigating the comparative roles of war and non-war trauma on the first onset of adulthood mood and anxiety disorders.

Methods: A nationally representative sample of 2,857 Lebanese was assessed using the World Health Organization Composite International Diagnostic Interview 3.0. with the onset of exposure to trauma and of first onset of mood and anxiety disorders.

Results: Non-war childhood traumata especially those belonging to family malfunctioning continue to exert their effect for the first time well beyond their occurrence as they were the most universal predictors for adult onset of both mood and anxiety disorders. War trauma during childhood predicted mood anxiety and mood (anxiety only in males) only below age 18 y. war childhood trauma predicts the first onset of mood and anxiety disorders before age 18 y in females, but only anxiety in males.

Conclusion: Childhood traumata are not equal in predicting the first onset of mood and anxiety disorders into adulthood. Family malfunctioning looks to carry the longest such risk and war more of shorter immediate effects. This might change though with re-exposure to war in adulthood which might unravel dormant vulnerability.

Keywords: Adult-onset; Anxiety disorders; Childhood adversities; Family malfunctioning; Mood disorders; Trauma; War exposure.