Adverse childhood experiences as a risk factor for depression-overweight comorbidity in adolescence and young adulthood

Fanny Kilpi, Ana Luiza Goncalves Soares, Laura D Howe
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Abstract

Background The comorbidity of depression and overweight is a manifestation of mental-physical multimorbidity, a marker of complex healthcare needs. We sought to examine how adverse childhood experiences (ACEs) are associated with depression-overweight comorbidity in the period of adolescence and early adulthood, and the extent to which associations are sensitive to age, sex and socioeconomic background. Methods Using data from 4734 adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort we estimated relative risk ratios (RRR) for the associations of multiple ACEs (physical, emotional, and sexual abuse, emotional neglect, being bullied, parental substance abuse, violence between parents, parental criminal conviction, parental separation, parental mental illness or suicide) with depression only, overweight only or their comorbidity at ages 17 and 24. We tested whether associations differed by sex and socioeconomic background, indicated by parental education. Results Most ACEs were associated with depression-overweight comorbidity, and there was a dose-response relationship whereby a greater number of ACEs was associated with greater risk and this continued from adolescence to young adulthood. Some ACEs associations with comorbidity appeared to be influenced by sex: at age 17, females had stronger associations for parental separation and mental health problems, and at age 24, sexual abuse had a stronger association in males. We did not find evidence that the sensitivity to ACEs varied by parental education. Conclusions ACEs across childhood are associated with depression-overweight comorbidity in late adolescence, which demonstrates their potential impact on the early manifestation of complex healthcare needs.
童年的不良经历是青春期和青年期抑郁-体重超重并发症的风险因素
背景抑郁症和超重的并发症是精神-身体多病性的一种表现,是复杂的医疗保健需求的标志。我们试图研究不良童年经历(ACE)与青少年期和成年早期抑郁-超重并发症的关系,以及这种关系对年龄、性别和社会经济背景的敏感程度。方法 我们利用雅芳父母与子女纵向研究(ALSPAC)出生队列中 4734 名青少年的数据,估算了 17 岁和 24 岁时多种 ACE(身体、情感和性虐待、情感忽视、被欺凌、父母药物滥用、父母间暴力、父母犯罪、父母离异、父母精神疾病或自杀)与单纯抑郁、单纯超重或其合并症的相对风险比(RRR)。我们测试了不同性别和社会经济背景(以父母教育程度为指标)之间的关联是否存在差异。结果 大多数 ACE 与抑郁-超重并发症相关,并且存在剂量-反应关系,即 ACE 越多,风险越大,这种关系从青春期一直持续到青年期。一些 ACE 与合并症的关系似乎受到性别的影响:17 岁时,女性与父母离异和精神健康问题的关系更密切;24 岁时,男性与性虐待的关系更密切。我们没有发现证据表明,父母的教育程度不同,对 ACE 的敏感度也不同。结论 童年时期的 ACE 与青少年晚期的抑郁-超重合并症有关,这表明它们对复杂的医疗保健需求的早期表现具有潜在影响。
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