Association between childhood neglect and psychiatric disorders in adults: systematic review, meta-analysis and meta-regression.
BACKGROUND Adverse childhood experiences are critical contributors to the development of psychiatric disorders. Despite its pervasive impact on mental health, childhood neglect remains underexplored. Here, we performed a first comprehensive synthesis of the association between neglect subtypes and psychiatric disorders. AIMS The primary aim was to quantify the overall association between neglect and psychiatric disorders, by estimating the odds ratios from clinical and control groups. The secondary aim was to examine the association between unspecified, physical and emotional neglect, and specific psychiatric disorders. METHOD Studies were systematically selected from three databases (PubMed, EMBASE and PsycINFO), focusing on adult populations with diagnosed psychiatric disorders and corresponding control groups. Meta-analyses assessed overall associations between neglect and psychiatric disorders, as well as subtypes-specific associations with distinct psychiatric conditions. Multiple meta-regressions were performed to explore moderating factors. RESULTS Strong associations were found between neglect and psychiatric disorders across all subtypes (unspecified neglect: odds ratio 3.63, 95% CI 2.19-6.01; physical neglect: odds ratio 3.27, 95% CI 2.51-4.25; emotional neglect: odds ratio 3.36, 95% CI 2.58-4.38). Subgroup analyses showed the strongest associations between unspecified neglect and bipolar disorder, physical neglect and schizophrenia spectrum disorders, and emotional neglect and major depressive disorder. Other associations emerged, although their interpretation was limited by a small number of studies and high heterogeneity levels. CONCLUSIONS Neglect is significantly associated with psychiatric disorders, with distinct patterns across neglect subtypes and mental health outcomes. These findings highlight the need for early identification and tailored interventions to mitigate neglect's long-term burden on mental health.