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3.08.2016

Dr. Charles B. Nemeroff Publishes Comprehensive Review of Consequences of Child Abuse and Neglect

In the early 1980s, psychiatrist Charles B. Nemeroff, M.D., Ph.D., began studying the links between early childhood abuse and neglect and long-term emotional, cognitive and physical problems in adults. It was a new approach to research that contradicted established psychiatric thinking at the time. Drawing from evidence presented by his patients and studies of the brains of laboratory animals, Nemeroff found childhood traumas can have lasting effects on the brain and metabolic systems, as well as changes in the expression of certain genes.

“Clinical studies over several decades have led to one inexorable conclusion — namely that sexual, physical and emotional abuse, as well as emotional neglect, lead to a very significant increase in risk in adulthood for mood and anxiety disorders, substance and alcohol abuse, and other medical disorders,” said Nemeroff, who is the Leonard M. Miller Professor and Chairman of Psychiatry and Behavioral Sciences, Director of the Center on Aging, and Chief of Psychiatry at Jackson Memorial Hospital and University of Miami Hospital.

“Exposure to early life stress in the form of child abuse or neglect is also associated with chronic health problems, including obesity, migraines, cardiovascular disease and diabetes,” said Nemeroff, whose comprehensive review, “Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect,” was published March 2 in the journal Neuron.

Noting the magnitude of this public health problem, Nemeroff said the U.S. Department of Health and Human Services in 2012 documented 3.4 million referrals to child protective services, representing 686,000 children. In this report, ELS involved neglect (78.3 percent), physical abuse (18.3 percent) and sexual abuse (9.3 percent).

Nemeroff said that a better understanding of neurobiological, metabolic, molecular and cellular mechanisms may lead to more effective clinical therapies in the future.

“We know that psychotherapy, antidepressants and other medications are effective for some patients, but not others,” he said. “That differential response to treatment may be rooted in the body’s response to early life stress.”

For example, neuroimagery studies indicate that the brain activity differs between depressed patients who have experienced childhood abuse and neglect, and those who have not.

“In addition,” said Nemeroff, “the course of psychiatric disorders in individuals exposed to childhood maltreatment tends to be more severe and less responsive to conventional treatment.”

Nemeroff noted that researchers have uncovered several genetic variations that may be linked to mood and anxiety disorders in patients who have been exposed to early life stress.

“That points to the possibility of developing novel pharmacological treatment strategies that might address the genetic vulnerabilities in certain patients,” he said.

Last year, Nemeroff was honored by the International Society of Psychoneuroendocrinology (ISPNE) with its 2015 Lifetime Achievement Award for his research into the biological basis of depression and other neuropsychiatric disorders.

Nemeroff has received numerous honors during his career, including the Kempf Award in Psychobiology (1989) and the Samuel Hibbs Award (1990) from the American Psychiatric Association, and the Gold Medal Award and the Research Prize (1996) from the Society of Biological Psychiatry. In 1993, he was awarded the Edward J. Sachar Award from Columbia University and the Edward A. Strecker Award from The Institute of the Pennsylvania Hospital.

Nemeroff also received the Menninger Prize from the American College of Physicians in 2000, the Research Award from the American Foundation for Suicide Prevention in 2001, and the Burlingame Prize from the Institute of Living in 2002. He is a member of the National Academy of Medicine, formerly the Institute of Medicine.

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