Dataset Information

Adverse childhood experiences in early life increase the odds of depression among adults with multiple sclerosis.

ABSTRACT:

Background

Adverse childhood experiences are demonstrated risk factors for depression, a common co-morbidity of multiple sclerosis, but are understudied among people with multiple sclerosis.

Objective

Estimate the association between adverse childhood experiences and depression among 1,990 adults with multiple sclerosis.

Methods

Participants were members of Kaiser Permanente Northern California from two studies between 2006 and 2021 and were diagnosed with multiple sclerosis by a neurologist. Adverse childhood experiences were assessed using two instruments, including the Behavioral Risk Factor Surveillance System. Participants self-reported ever experiencing a major depressive episode. Meta-analysis random effects models and logistic regression were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between adverse childhood experiences and a history of depression across study samples. Adverse childhood experiences were expressed as any/none, individual events, and counts. Models adjusted for sex, birth year, race, and ethnicity.

Results

Exposure to any adverse childhood experiences increased the odds of depression in people with multiple sclerosis (OR: 1.71, 95% CI: 1.21-2.42). Several individual adverse childhood experiences were also strongly associated with depression, including "significant abuse or neglect" (OR: 2.79, 95% CI: 2.11-3.68).

Conclusion

Findings suggest that adverse childhood experiences are associated with depression among people with multiple sclerosis. Screening for depression should be done regularly, especially among people with multiple sclerosis with a history of adverse childhood experiences.

SUBMITTER: Guerrero KS

PROVIDER: S-EPMC10552460 | biostudies-literature | 2023 Oct-Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Adverse childhood experiences in early life increase the odds of depression among adults with multiple sclerosis.

Guerrero Karla S KS Horton Mary K MK Choudhary Vidhu V Bellesis Kalliope H KH Dorin Pete P Mei Jin J Chinn Terrence T Meyers Travis J TJ Schaefer Catherine A CA Barcellos Lisa F LF

Multiple sclerosis journal - experimental, translational and clinical 20231004 4

<h4>Background</h4>Adverse childhood experiences are demonstrated risk factors for depression, a common co-morbidity of multiple sclerosis, but are understudied among people with multiple sclerosis.<h4>Objective</h4>Estimate the association between adverse childhood experiences and depression among 1,990 adults with multiple sclerosis.<h4>Methods</h4>Participants were members of Kaiser Permanente Northern California from two studies between 2006 and 2021 and were diagnosed with multiple sclerosi ...[more]

PMID: 37808459

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Project description:BackgroundAdverse Childhood Experiences (ACEs) include potentially traumatic exposures to neglect, abuse, and household problems involving substance abuse, mental illness, divorce, incarceration, and death. Past study findings suggest ACEs contribute to depression, while physical activity alleviates depression. Little is known about the link between ACEs and physical activity as it relates to depression among U.S. adults. This research had a primary objective of determining the role of physical activity within the link between ACEs and depression. The significance of this study involves examining physical activity as a form of behavioral medicine.MethodsData from the 2020 Behavioral Risk Factor Surveillance System were fit to Pearson chi-square and multivariable logistic regression models to examine the links between ACEs and depression, ACEs and physical activity, and physical activity and depression among U.S. adults ages 18-and-older (n = 117,204) from 21 states and the District of Columbia, while also determining whether physical activity attenuates the association between ACEs and depression.ResultsFindings from chi-square analyses indicated that ACEs are related to physical activity (χ2 = 19.4, df = 1; p<0.01) and depression (χ2 = 6,841.6, df = 1; p<0.0001). Regression findings suggest ACEs were linked to depression (AOR = 1.050; 95% CI = 1.049, 1.051). ACEs and physical activity (AOR = 0.994; 95% CI = 0.992, 0.995) and physical activity and depression (AOR = 0.927; 95% CI = 0.922, 0.932) were both inversely related. Physical activity mitigated the link between ACEs and depression (AOR = 0.995; 95% CI = 0.993, 0.996).ConclusionsThis research addressed a critical knowledge gap concerning how ACEs and physical activity contribute to depression outcomes among U.S. adults. Findings suggest physical activity mitigates the effect of ACEs on depression. Future studies should apply physical activity interventions to alleviate depression among U.S. adults with high ACEs.

Project description:ObjectiveAdverse childhood experiences (ACEs) are linked to worsening overall health outcomes and psychological diagnoses. Routine screening, particularly in patients with postpartum depression (PPD), would identify patients who could benefit from interventions to prevent the perpetuation of ACEs and establish a system of preventative care to mitigate the risks of adverse health outcomes associated with high ACE scores. The purpose of this study is to explore the link between ACEs and PPD to advocate for the use of the ACE questionnaire as a routine screening tool in all pregnant patients diagnosed with PPD. We hypothesize that a cohort of patients with PPD will be more likely to have high-risk ACE scores than the general female population.Study designOur IRB approved, retrospective cohort study identified all patients diagnosed with PPD at an academic medical center between January 2015 and December 2019. The subjects were identified using retrospective chart review. Subjects were recruited via telephone and asked to complete an ACE questionnaire. Questionnaires were sent via RedCap. ACE scores were calculated, categorized as 0, 1, 2, 3, or 4 or more ACEs, and compared to the prevalence in the original Kaiser-CDC ACE study female cohort using a chi-square goodness-of-fit test.ResultsThere were 132/251 surveys completed (53% response rate). In our PPD population, 19.3% had 0 ACEs, 17.0% had 1 ACE, 13.1% had 2 ACEs, 16.5% had 3 ACEs, and 34.1% had 4 or more ACEs. These percentages were significantly different from the Kaiser-CDC ACE Study percentages of 34.5, 24.5, 15.5, 10.3, and 15.2%, respectively (p < 0.001).ConclusionOur unique study showed that women with PPD are more likely to have high-risk ACE scores than the general female population. This finding has important implications in regards to counseling, intervening to prevent perpetual ACEs, and establishing important provider-patient relationships for life-long preventative care.Non-gendered language is used when possible throughout. However, the wording from studies cited in this paper was preserved.

Project description:ObjectiveTo investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these.MethodWe analysed baseline data from the Mitchelstown (Ireland) 2010-2011 cohort of 2047 men and women aged 50-69 years. Self-reported measures included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale) and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by ACE scores and ACE subtypes abuse, neglect and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors. We tested whether the estimated associations varied across levels of PSS (poor, moderate and strong).Results23.7% of participants reported at least one ACE (95% CI 21.9% to 25.6%). ACE exposures (overall, subtype or ACE scores) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. Exposure to any ACE (vs none) was associated with almost three times the odds of depressive symptoms (adjusted OR 2.85; 95% CI 1.64 to 4.95) among individuals reporting poor PSS, while among those reporting moderate and strong PSS, the adjusted ORs were 2.21 (95% CI 1.52 to 3.22) and 1.39 (95% CI 0.85 to 2.29), respectively. This pattern of results was similar when exposures were based on ACE subtype and ACE scores, though the interaction was clearly strongest among those reporting abuse.ConclusionsACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms, particularly among those with poor PSS. Interventions that enhance social support, or possibly perceptions of social support, may help reduce the burden of depression in older populations with ACE exposure, particularly in those reporting abuse.

Project description:BackgroundIt has been proposed that adverse childhood experiences (ACEs) can put women at risk for mental illness in the pregnancy and postpartum periods. While some studies have found strong support for this proposition, others have found weak or no support. This study is a meta-analysis of the association between ACEs and maternal mental health to resolve between-study discrepancies, and to examine potential moderators of associations.MethodsThree electronic databases (i.e., MEDLINE, Embase, and PsycINFO) were searched up to November 2018 by a health sciences librarian. A hand search was conducted in January 2020 and relevant studies were added. Included studies reported on associations between ACEs and maternal depression and/or anxiety in the perinatal period (pregnancy to 1-year postpartum). Pregnancy and postpartum outcomes were examined separately for both depression and anxiety. Random-effect meta-analyses were conducted. Moderator analyses were conducted using meta-regression. Study quality was evaluated using a 15-point scale.ResultsThe initial search yielded 4646 non-duplicate records and full text review occurred for 196 articles. A total of 15 studies (N = 7788) were included in the meta-analyses, of which 2 were also described narratively. Publication year ranged from 1998 to 2019. Mothers were approximately 28.93 years of age when they retrospectively reported on their ACEs. All studies had maternal self-report questionnaires for the mental health outcomes. Study quality ranged from 7 to 12. The pooled effect sizes between ACEs and prenatal (N = 12; r = .19; 95% CI= .13, .24) and postpartum (N = 7; r = .23; 95% CI = .06 to .39) depressive symptoms were significant. The pooled effect size between ACEs and prenatal anxiety was also significant (N = 5; r = .14; 95% CI= .07, .21). Moderator analyses indicated that timing of depressive and anxiety symptoms may be important for understanding associations.ConclusionsACEs confer risk to maternal mental health, albeit effect sizes are small to moderate in magnitude. Trauma-informed approaches, as well as increased mental health support during and after pregnancy, may help to offset the relative risk of ACEs on maternal mental health.

Project description:ImportanceStudies investigating the association of threat-related and deprivation-related adverse childhood experiences (ACEs) with later-life cognitive decline are lacking.ObjectivesTo evaluate the independent association of threat-related and deprivation-related ACEs with cognitive decline over time among middle-aged and older Chinese adults and to examine the modifying role of social isolation in such associations.Design, setting, and participantsThis prospective cohort study used cognitive data from the China Health and Retirement Longitudinal Study (CHARLS) baseline survey that was administered between June 1, 2011, and March 31, 2012, and the CHARLS follow-up survey administered between July 1 and September 30, 2015. The life history survey with information of ACEs was additionally administered between June 1 and December 31, 2014. Statistical analysis was performed from March 1 to July 31, 2022. The study population consisted of middle-aged and older adults (age range, 45-97 years) with complete data on ACEs and 2 cognitive assessments and without cognitive impairment at baseline.ExposuresFive threat-related ACEs (ie, physical abuse, household substance abuse, domestic violence, unsafe neighborhood, and bullying) and 5 deprivation-related ACEs (ie, emotional neglect, household mental illness, incarcerated household member, parental separation or divorce, and parental death) before 17 years of age were queried by questionnaires. The cumulative scores of the 2 ACE dimensions were calculated and grouped into 3 categories as 0, 1, and 2 or more in main analyses.Main outcomes and measuresCognitive function was measured by episodic memory and executive function. Global cognition was further calculated as the total score of these 2 dimensions. The raw scores of each cognitive test were standardized to z scores using baseline means and SDs. Linear mixed-effects models were constructed to examine the association between 2 dimensions of ACEs and the rate of annual cognitive decline. The modifying role of baseline social isolation in such associations was assessed with 3-way interaction tests.ResultsOf the 6466 participants included in main analyses, 3301 (51.1%) were men and the mean (SD) age was 57.2 (8.3) years. Compared with no exposures, experience of 1 deprivation-related ACE was associated with faster cognitive decline in global cognition (β = -0.012 [95% CI, -0.022 to -0.002] SD/y) and executive function (β = -0.010 [95% CI, -0.020 to -0.00002] SD/y), whereas individuals with at least 2 childhood deprivations had faster cognitive declines in all cognitive tests (β = -0.035 [95% CI, -0.050 to -0.019] SD/y for global cognition; β = -0.047 [95% CI, -0.068 to -0.025] SD/y for episodic memory; β = -0.019 [95% CI, -0.034 to -0.004] SD/y for executive function). However, such an association was not observed for threat-related ACEs. In addition, baseline social isolation was a significant modifier in the associations between deprivation-related ACEs and cognitive declines in global cognition (β = -0.033 [95% CI, -0.061 to -0.005] SD/y; P = .02 for 3-way interaction) and executive function (β = -0.032 [95% CI, -0.059 to -0.005] SD/y; P = .02 for 3-way interaction).Conclusions and relevanceDeprivation-related ACEs, but not threat-related ACEs, were associated with faster decline in later-life cognitive function, whereas social isolation could modify such detrimental impact. These findings highlight the potential benefits of promoting social integration in maintaining later-life cognitive function among individuals who have experienced childhood deprivation.

Dataset Information

Adverse childhood experiences in early life increase the odds of depression among adults with multiple sclerosis.

Background

Objective

Methods

Results

Conclusion

Publications

Adverse childhood experiences in early life increase the odds of depression among adults with multiple sclerosis.

Similar Datasets

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