We Are Adult Survivors of Child Abuse and Neglect

It seems like most of the coverage about mental health disorders in the media these days is primarily presented by pharmaceutical companies in their desire to sell pills. And the main ones discussed are those affecting people diagnosed with Depression, Bipolar Disorder, Schizophrenia and Autism. Research gives us a more accurate picture of both the scope of mental illnesses and the major disorders affecting Americans.

Over 1/4 of American’s age 18 and older are diagnosed with a mental disorder in any given year. The 2004 U.S. Census data determined that figure to be about 58 million people. And the leading cause of disability for ages 15-44 are mental disorders. It is important to note that many people ususally have more than one disorder at a time.¹

Listed below are the statistics for disorders for the U.S. population most of which are for age 18 and older in any given year. There are seven categories. Depression and Bipolar fall into one category, Schizophrenia and Autism have their own category.

MOOD DISORDERS:  Major Depressive Disorder, Dysthymic (Despondent) Disorder, and Bipolar Disorder

• Mood Disorders in General
  • Approximately 21 million or 9.5 percent.
  • Median age of onset is 30 years.
  • Co-occur with anxiety disorders and substance abuse.
• Major Depressive Disorder
  • Approximately 14.8 million or 6.7 percent.
  • Median age of onset is 32.
  • Major Depressive Disorder is the leading cause of disability for ages 15-44.
  • Major Depressive Disorder is more prevalent in women than in men.
• Dysthymic Disorder
  • Approximately 3.3 million or 1.5 percent.
  • Median age of onset is 31.
  • Must have chronic, mild depression for at least 2 years (1 year for children) to meet the criteria for the diagnosis.
• Bipolar Disorder
  • Approximately 5.7 million or 2.6 percent.
  • Median age of onset is 25.
• Suicide
  • In 2004, 32,439 people died by suicide.
  • More than 90 percent had a diagnosable mental disorder, most commonly a depressive or substance abuse disorder.
  • Four times as many men die by suicide; however, women attempt suicide two or three times as often as men.

ANXIETY DISORDERS:  Panic Disorder, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder (PTSD), Generalized Anxiety Disorder, and Phobias (Social, Agoraphobia, and Specific)

• Anxiety Disorders in General
  • Approximately 40 million or 18.1 percent.
  • Frequently co-occur with depressive disorders or substance abuse.
  • Nearly ¾ of those with an anxiety disorder will have their first episode by age 21.5.
• Panic Disorder
  • Approximately 6 million or 2.7 percent.
  • Median age of onset is 24.
  • About 1 in 3 people with panic disorder develops agoraphobia, a condition where a person becomes afraid of being unable to escape or get help.
• Obsessive-Compulsive Disorder
  • Approximately 2.2 million or about 1 percent.
  • Median age of onset is 19.
• Posttraumatic Stress Disorder (PTSD)
  • Approximately 7.7 million or about 3.5 percent.
  • Median age of onset is 23.
  • About 19 percent of Vietnam veterans experience PTSD at some point.
  • This disorder also frequently occurs after violent personal assaults such as rape, mugging, or domestic violence; terrorism; natural or human-caused disasters; and accidents.
• Generalized Anxiety Disorder
  • Approximately 6.8 million or about 3.1 percent.
  • Median age of onset is 31.
• Agoraphobia
  • Approximately 1.8 million or about 0.8 percent.
  • Median age of onset is 20.
• Specific Phobia
  • Approximately 19.2 million or about 8.7 percent.
  • Median age of onset is 7.
  • Involves marked and persistent fear and avoidance of a specific object or situation.

EATING DISORDERS:  Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder

• Anorexia Nervosa
  • Approximately 2 million or 1 percent of young women between 10-20 years old.
• Bulimia Nervosa
  • Approximately 8 million or 4 percent of college-age women.
• Binge-Eating
  • Approximately 4 million or 2 percent.
  • While binge-eating is not listed in the DSM-IV as an eating disorder, it is very problematic in today’s society.
  • Females are much more likely than males to develop an eating disorder.
  • The mortality rate among people with Anorexia is about 12 times higher than the annual death rate due to all causes of death among females ages 15 – 24.

ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

• Approximately 8 million or 4 percent ages 18 – 44.
• Median age of onset is 7.

AUTISM

• Approximately 1.5 million or 1.5 percent.
• Generally diagnosed by age 3.

ALZHEIMER’S DISEASE

• Approximately 4.5 million or 2.5 percent.
• Median age of onset is 65.
• 1 in 10 over 65 and nearly half of those over 85 are affected.

SCHIZOPHRENIA

• Approximately 3.2 million or 1.5 percent.
• Affects men and women with equal frequency.
• Often first appears in men in their late teens or early 20s. In contrast, women are generally affected in their 20s or early 30s.

It is interesting to note that the Dissociative Disorders are not mentioned at all by NIMH.  Dissociative Identity Disorder (DID – formerly known as Multiple Personality Disorder) and other Dissociative Disorders are now understood to be fairly common effects of severe trauma in early childhood, most typically extreme, repeated physical, sexual, and/or emotional abuse. Current research shows that DID may affect about 2.5 million or 1 percent of the general population and as many as 5-20 percent of people in psychiatric hospitals.²

From reviewing the above statistics we find that while Schizophrenia and Autism are very severe, debilitating, biological illnesses which certainly require research and funding, these illnesses are rare and each represent only 1.5 percent of the population.

Most people in the United States, however, experience the Mood and Anxiety Disorders (which include Depression and Bipolar). Mood and Anxiety Disorders represent 9.5 and 18.1 percent of the population, respectively. And most survivors are diagnosed with these disorders which includes PTSD at 3.5 percent of the population.

One in four girls and one in six boys will be sexually assaulted in the United States before they reach the age of 18.  ³

It is incomprehensible that tens of millions of survivors suffer from these disorders and yet there is no public dialogue about it. It is time that the mental disorders of child abuse survivors also become front-page news with more research and discussion.

1. Mental Health Statistics, National Institute of Mental Health, 2006 [↩]
2. What is Dissociative Disorder?, Sidran 2007 [↩]
3. Botash, Ann, MD. “Examination for Sexual Abuse in Prepubertal Children:  An Update” Pediatric Annual, May 1997 [↩]