Childhood trauma is prevalent and associated with co-occurring depression, anxiety, mania and psychosis in young people attending Australian youth mental health services

Objectives Childhood trauma is common and associated with mental ill health. While high rates of trauma are observed across individual disorder groups, there is evidence that trauma is associated with an admixture of affective, anxiety, and psychotic symptoms in adults. Given that both early onset of mental disorder and trauma exposure herald poor outcomes, it is important to examine trauma prevalence rates in youth mental health services and to determine whether this trauma-related clustering is present in help-seeking young people. Methods We used data from the Transitions Study, a longitudinal investigation of young people attending one of four headspace youth mental health services in Melbourne and Sydney, Australia between January 2011 and August 2012. Participants were 775 young people aged 12 to 25 (65.9% female; mean age = 18.3, SD = 3.2). Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Multinomial regression was used to assess whether reported childhood trauma was more strongly associated with the co-occurrence of depression, anxiety, mania, and psychosis symptoms than with any one in isolation. Results Approximately 84% of participants reported some form of abuse (emotional: 68%; physical: 32%; sexual: 22%) or neglect (emotional: 65%; physical: 46%) during childhood or adolescence. Exposure to multiple trauma types was common. Childhood trauma was significantly associated with each symptom domain (depression, mania, anxiety and psychosis). Childhood trauma was more strongly associated with the co-occurrence of these symptoms than with any one of these domains in isolation, such that trauma-exposed young people were more likely to experience increased symptom clustering than their non-exposed counterparts. Conclusions Childhood trauma is pervasive in youth mental health services and associated with a heterogeneous symptom profile that cuts across traditional diagnostic boundaries. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by the Australian National Health and Medical Research Council [grant number 556529]. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committees of the University of Melbourne and the University of Sydney gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes ll data produced in the present work are contained in the manuscript