Evidence map›Paper›PMID 41146110›Full record

ArticleBMC public health2025

Childhood maltreatment and adult diseases in the general population: the mediating role of smoking and overweight in a time-sequence design.

Johanna Klinger-König, Fabian Streit, Maja P Völker, Josef Frank, Peggy Sekula, Stefanie Jaskulski, Michael Leitzmann, Claudia Meinke-Franze, Carsten O Schmidt, Thomas Keil and 16 more

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Johanna Klinger-KönigDepartment of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, Greifswald, D-17489, Germany. johanna.klinger-koenig@med.uni-greifswald.de.
Fabian StreitDepartment of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Maja P VölkerDepartment of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Josef FrankDepartment of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Peggy SekulaInstitute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
Stefanie JaskulskiInstitute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
Michael LeitzmannInstitute for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Claudia Meinke-FranzeInstitute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Carsten O SchmidtInstitute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Thomas KeilInstitute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Stefan N WillichInstitute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Tobias PischonMolecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.
Ilais M VelásquezMolecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.
Jonas FrostInstitute for Medical Epidemiology, Biometrics, and Informatics, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Germany.
Börge SchmidtInstitute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.
Jana-Kristin HeiseDepartment of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany.
Carolina J Klett-TammenDepartment of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany.
Lena Koch-GallenkampDivision of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Nadia ObiInstitute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Volker HarthInstitute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Ute MonsDivision Primary Cancer Prevention, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Klaus BergerInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Karin H GreiserDivision of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Rafael MikolajczykInstitute for Medical Epidemiology, Biometrics, and Informatics, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Germany.
Matthias B SchulzeDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Hans J GrabeDepartment of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, Greifswald, D-17489, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildhood maltreatment is associated with an unhealthier lifestyle in adulthood and an increased risk of mental and somatic health problems, although the underlying pathways remain unclear. This study examined whether smoking and overweight mediate the association between childhood abuse/neglect and frequent adult diseases, including cancer, myocardial infarction, stroke, type 2 diabetes, chronic obstructive pulmonary disease, depression, and anxiety.

methodsChildhood maltreatment was assessed in 152,887 German National Cohort (NAKO) participants using the Childhood Trauma Screener. Information on smoking initiation age, weight history, and respective age at diagnosis was incorporated to ensure that smoking and overweight preceded the diagnosis. Mediation analyses were adjusted for age, sex, study center, and education.

resultsFor childhood abuse, larger proportions of associations with adult somatic diseases were mediated through preexisting smoking and overweight compared to adult mental disorders. Smoking most strongly mediated myocardial infarction (36.88% [95% confidence interval (CI): 17.88%; 55.89%]), with more pronounced effects in men (48.62% [14.28%; 82.97%]) than in women (20.82% [2.75%; 38.89%]). For overweight, a substantial mediation was only found for type 2 diabetes (13.69% [9.85%; 17.52%]), with stronger effects in women (16.16% [8.92%; 23.39%]) compared to men (8.43% [4.52%; 12.35%]). Comparable results were found for childhood neglect.

conclusionsTo smoke or be overweight before the first diagnosis of myocardial infarction and type 2 diabetes mediated the association between childhood abuse/neglect and these somatic diseases. However, while the mediation through smoking and overweight contributed to the disease risk linked to childhood maltreatment, strong direct effects of childhood abuse/neglect persisted for both mental and somatic health problems. These findings underscore the need for further longitudinal studies to better understand the pathways.

Indexed as

Adult Survivors of Child AbuseChild AbuseOverweightSmokingAdultAgedChildCohort StudiesDiabetes Mellitus, Type 2FemaleGermanyHumansMaleMiddle AgedRisk FactorsAge of onsetChildhood abuseChildhood neglectChronic non-communicable diseasesMental health

Identifiers

PMID41146110
PMCPMC12560492

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