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Childhood Trauma in Multiple Sclerosis: A Case-Control Study

Spitzer, Carsten MD; Bouchain, Miriam; Winkler, Liza Y. MD; Wingenfeld, Katja PhD; Gold, Stefan M. PhD; Grabe, Hans Joergen MD; Barnow, Sven PhD; Otte, Christian MD; Heesen, Christoph MD

doi: 10.1097/PSY.0b013e31824c2013
Original Articles

Objective: To investigate the association between childhood trauma and multiple sclerosis (MS) by comparing histories of child abuse and neglect between patients with MS and adults from the general population in a cross-sectional case-control study. Previous research has demonstrated a connection between MS and a variety of emotional stressors, but childhood trauma, which is known to have long-lasting negative consequences for physical health decades into adulthood, has not been studied.

Methods: The self-reported Childhood Trauma Questionnaire for the assessment of emotional, physical, and sexual abuse and emotional and physical neglect was administered to 234 patients with definite MS and 885 adults from the general population.

Results: After adjusting for sociodemographic factors and current depression, patients with MS scored significantly higher in all Childhood Trauma Questionnaire subscales apart from physical abuse and neglect than adults from the general population. Adjusted odds ratios for these types of childhood trauma were higher in the MS group than in controls, ranging from 2.0 for emotional neglect (95% confidence interval = 1.3–3.2) to 3.4 for emotional abuse (95% confidence interval = 2.0–5.7). Although childhood trauma was not associated with the degree of current MS-related disability, patients with MS with histories of physical and/or sexual abuse had significantly higher relapse rates than patients without early-life stress.

Conclusions: Our findings suggest an association between childhood trauma and MS in this cross-sectional study. Larger prospective longitudinal studies are needed to clarify the relationship between early-life stress and the risk for MS in genetically susceptible individuals.

Abbreviations: MS = multiple sclerosis; SDMT = Symbol Digit Modalities Test; CTQ = Childhood Trauma Questionnaire; EDSS = Expanded Disability Status Scale

From the Department of Psychosomatic Medicine and Psychotherapy (C.S., K.W.), University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek; and Institute of Neuroimmunology and Clinical MS Research and Department of Neurology (M.B., L.Y.W., S.M.G., C.H.), University Medical Center Hamburg-Eppendorf, Hamburg; Department of Psychiatry and Psychotherapy (K.W., C.O.), Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Berlin; Department of Psychiatry and Psychotherapy (H.J.G.), Ernst-Moritz-Arndt-University, Greifswald; and Institute of Psychology (S.B.), Ruprecht-Karls University, Heidelberg, Germany.

Address correspondence and reprint requests to Carsten Spitzer, MD, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek, Martinistr. 52, 20246 Hamburg, Germany. E-mail: c.spitzer@uke.uni-hamburg.de

The Study of Health in Pomerania is part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (Grant nos. 01ZZ9603, 01ZZ0103, and 01ZZ0403), the Ministry of Cultural Affairs, and the Social Ministry of the Federal State of Mecklenburg-West Pomerania. This work was also partly funded by the German Research Foundation (GR 1912/5-1).

Received for publication January 18, 2011; revision received October 11, 2011.

Copyright © 2012 by American Psychosomatic Society
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