The risk for adverse consequences and disease due to the trauma of child abuse or neglect is easily assessed using the self-administered modified ACEs questionnaire. Exposure to child maltreatment is endemic and common. At least one out of every ten USA adults has a significant history of childhood maltreatment. This is a review of the literature documenting that a past history of childhood abuse and neglect (CAN) makes substantial contributions to physical disease in adults, including asthma, chronic obstructive pulmonary disease, lung cancer, hypertension, stroke, kidney disease, hepatitis, obesity, diabetes, coronary artery disease, pelvic pain, endometriosis, chronic fatigue syndrome, irritable bowel syndrome, fibromyalgia, and auto immune diseases. Adults who have experienced child maltreatment have a shortened life expectancy. The contribution of CAN trauma to these many pathologies remains largely underappreciated and neglected compared to the attention given to the array of mental illnesses associated with child maltreatment. Specific pathophysiolologic pathways have yet to be defined. Clinical recognition of the impact of past CAN trauma will contribute to the healing process in any disease but identifying specific effective therapies based on this insight remains to be accomplished. Recommendations are made for managing these patients in the clinic. It is important to incorporate screening for CAN throughout adult medical practice now.

使用自我管理的修改后的 ACEs 问卷很容易评估由于虐待或忽视儿童的创伤而导致的不良后果和疾病的风险。遭受虐待儿童是地方性的和普遍的。每十个美国成年人中至少有一个有严重的童年虐待史。这是对文献的回顾，这些文献记录了儿童虐待和忽视 (CAN) 的过去历史对成人身体疾病的重大贡献，包括哮喘、慢性阻塞性肺病、肺癌、高血压、中风、肾病、肝炎、肥胖症、糖尿病、冠状动脉疾病、盆腔痛、子宫内膜异位症、慢性疲劳综合症、肠易激综合症、纤维肌痛和自身免疫疾病。经历过虐待儿童的成年人的预期寿命会缩短。与对与虐待儿童相关的一系列精神疾病的关注相比，CAN 创伤对这些疾病的贡献在很大程度上仍然被低估和忽视。具体的病理生理学途径尚未确定。对过去 CAN 创伤影响的临床认识将有助于任何疾病的愈合过程，但基于这一认识确定特定的有效疗法仍有待完成。提出了在诊所管理这些患者的建议。现在在整个成人医疗实践中纳入 CAN 筛查非常重要。具体的病理生理学途径尚未确定。对过去 CAN 创伤影响的临床认识将有助于任何疾病的愈合过程，但基于这一认识确定特定的有效疗法仍有待完成。提出了在诊所管理这些患者的建议。现在在整个成人医疗实践中纳入 CAN 筛查非常重要。具体的病理生理学途径尚未确定。对过去 CAN 创伤影响的临床认识将有助于任何疾病的愈合过程，但基于这一认识确定特定的有效疗法仍有待完成。提出了在诊所管理这些患者的建议。现在在整个成人医疗实践中纳入 CAN 筛查非常重要。