Health-related quality of life after child maltreatment in institutions: Results from a representative population-based sample in Germany

Background: Child maltreatment (CM) is a major public health problem associated with enormous consequences, including impaired health-related quality of life (HRQOL). While the consequences of CM that occurs in the family context have been studied numerous times, studies on the con-sequences of institutional CM are lacking. This is of particular importance because cases of CM in churches, sport clubs and school, educational and medical settings have become increasingly apparent in Germany. Objective: Thus, the objective of this study was to assess the association of CM in various institutions with HRQOL in adulthood. Participants and setting: In a cross-sectional observational approach, a representative sample of the German population (N = 2516) was identified via a randomroute.Methods: Socioeconomic information, HRQOL and CM experiences in school, medical and educational institutions were obtained and statistically evaluated.Results: Of the 2516 participants, 834 (33.14 %) reported CM in institutions and 1194 (47.46 %) reported impaired HRQOL. Participants who reported CM in institutions were more likely to have HRQOL impairments than participants who had been in the respective institution in childhood but had not reported having experienced CM there. In the case of CM in medical institutions, HRQOL impairments increased 2.2-3.9-fold. If CM in school was reported, HRQOL impairments increased 1.6-2.0-fold. If CM in educational institutions was reported, HRQOL impairments increased 2.1-2.7-fold.Conclusions: CM in institutions is associated with an increased likelihood of HRQOL impairments in Germany. Institutions need to be aware of the risk of CM and safeguarding measures should be implemented.