Prevalence and transient impact of childhood abuse and neglect on health-related quality of life in Mexican patients with early rheumatoid arthritis.

INTRODUCTION: Adverse childhood experiences are risk factors for rheumatic diseases outcomes. Prospective studies from low- and middle-income countries remain limited. This study aimed to estimate the prevalence of childhood abuse and neglect (CAN) in Mexican patients with recent-onset rheumatoid arthritis (RA) and to evaluate its impact on outcomes during the first year of follow-up. PATIENTS AND METHODS: This nested cross-sectional study was conducted within an ongoing prospective cohort initiated in 2004, with data collected from June to December 2025. Clinical, laboratory, and patient-reported outcomes were collected throughout patient follow-up. In 2025, CAN was introduced as a key outcome, assessed and defined by self-report and using a locally developed and validated 29-item scale encompassing six dimensions. Raw scores for each of the eight SF-36 domains were determined. The area under the curve was calculated for each cumulative outcome. Adjusted linear regression models were used to evaluate the association between CAN and outcomes scores. RESULTS: Among 156 patients, 41 (26.3%) met criteria for CAN. CAN was significantly associated with lower scores in the physical functioning, role-physical, social functioning, and pain domains of the SF-36. CAN did not have a significant impact on other baseline outcomes. High baseline disease activity impacted all the SF-36 domains. The impact of CAN on cumulative SF-36 domain scores was no longer observed early during follow-up. CONCLUSIONS: CAN was reported by one in four Mexican patients in an early RA cohort, and was associated with a significant, albeit temporary, reduction in some dimensions of health-related quality of life. Keypoints • Childhood abuse or neglect was reported by 26.3% of patients with recent-onset rheumatoid arthritis. • Childhood abuse or neglect and high baseline disease activity were associated with poorer first-year health-related quality of life. • The negative impact of childhood abuse or neglect on health-related quality of life was no longer evident after 2 months of early treatment.