Adverse childhood experiences and psychiatric comorbidity in multiple sclerosis, inflammatory bowel disease, and rheumatoid arthritis in the Canadian longitudinal study on aging

IF 3.5 2区 医学 Q2 PSYCHIATRY Journal of Psychosomatic Research Pub Date : 2024-09-13 DOI:10.1016/j.jpsychores.2024.111893
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Abstract

Objectives

Adverse childhood experiences (ACE) are associated with immune-mediated inflammatory diseases (IMID). We evaluated whether: (i) ACE associate with psychiatric comorbidity among individuals with IMID, including rheumatoid arthritis (RA), multiple sclerosis (MS), and inflammatory bowel disease (IBD); (ii) whether psychiatric disorders mediate the relationship between ACE and IMID; and (iii) whether these findings differ from those in individuals with other chronic physical disorders.

Methods

Using data from the Canadian Longitudinal Study on Aging (CLSA) we performed a retrospective case-control study of participants aged 45–85 years recruited between 2010 and 2015. ACE were queried using questions derived from the Childhood Experiences of Violence Questionnaire-Short Form and the National Longitudinal Study of Adolescent to Adult Health Wave III questionnaire. We used multivariable logistic regression and causal mediation analysis to address our objectives.

Results

We included 13,977 CLSA participants. Among the 31 % of IMID participants who reported a comorbid psychiatric disorder, 79 % reported a history of ACE. ACE associated with increased odds (OR [95 % CI]) of a psychiatric disorder (2.55 [1.02–6.35]) among participants with IMID; this did not differ across IMID. The total effect (OR [95 % CI]) of ACE on IMID was 1.11 (1.07–1.16), of which 10.60 % (8.04–17.47) was mediated by psychiatric disorders. We found similar associations among participants with other chronic physical disorders.

Conclusion

Our findings suggest that psychiatric disorders partially mediate the association between ACE and IMID. Most participants with IMID and comorbid psychiatric disorders report a history of ACE and may benefit from trauma-informed mental health care.

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加拿大老龄问题纵向研究中多发性硬化症、炎症性肠病和类风湿性关节炎患者的童年不良经历和精神病合并症
目的 儿童时期的不良经历(ACE)与免疫介导的炎症性疾病(IMID)有关。我们评估了:(i) ACE 是否与 IMID(包括类风湿性关节炎 (RA)、多发性硬化症 (MS) 和炎症性肠病 (IBD))患者的精神疾病合并症有关;(ii) 精神疾病是否介导 ACE 与 IMID 之间的关系;(iii) 这些研究结果是否与其他慢性身体疾病患者的研究结果不同。方法利用加拿大老龄化纵向研究(CLSA)的数据,我们对 2010 年至 2015 年间招募的 45-85 岁参与者进行了一项回顾性病例对照研究。我们使用源自童年暴力经历问卷-简表和全国青少年到成人健康纵向研究第三波问卷的问题对ACE进行了询问。我们使用多变量逻辑回归和因果中介分析来实现我们的目标。在31%报告合并有精神障碍的IMID参与者中,79%报告有ACE病史。在 IMID 参与者中,ACE 与精神障碍的几率(OR [95 % CI])增加有关(2.55 [1.02-6.35] );这在不同 IMID 中并无差异。ACE对IMID的总效应(OR [95 % CI])为1.11(1.07-1.16),其中10.60 %(8.04-17.47)由精神障碍介导。结论我们的研究结果表明,精神疾病在一定程度上介导了 ACE 与 IMID 之间的关系。大多数患有 IMID 且合并有精神障碍的参与者都报告了 ACE 病史,他们可能会受益于以创伤为基础的心理健康护理。
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来源期刊
Journal of Psychosomatic Research
Journal of Psychosomatic Research 医学-精神病学
CiteScore
7.40
自引率
6.40%
发文量
314
审稿时长
6.2 weeks
期刊介绍: The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.
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