Home Medizin Widrigkeiten in der Kindheit stehen in engem Zusammenhang mit psychischen Erkrankungen bei Erwachsenen

Widrigkeiten in der Kindheit stehen in engem Zusammenhang mit psychischen Erkrankungen bei Erwachsenen

von NFI Redaktion

Recent data from a large registry study with twins shows that adverse childhood experiences (ACEs) are significantly associated with an increased risk of depressive, anxiety, and stress-related disorders in adulthood.

Researchers found that each additional unwanted event increases the risk of a psychiatric disorder in adults by 52%, with sexual abuse posing the greatest risk.

The results indicated that the connection persisted even after accounting for common genetic and environmental factors.

The findings suggest that „interventions targeting ACEs, including primary prevention and improved access to evidence-based trauma therapies for individuals who have experienced ACEs, could be associated with a reduced risk of future psychopathologies,“ the researchers, along with lead author Hilda Björk Daníelsdóttir, MSc. from the University of Iceland, Reykjavik, Iceland, wrote.

The results were published online on March 6 in JAMA Psychiatry.

Dose-Dependent Effect

Prior studies have shown a clear link between child abuse and an increased risk of psychiatric disorders in adulthood, but evidence for this relationship in studies accounting for familial confounding factors is „completely lacking,“ the researchers wrote.

To learn more about how genetic factors may influence the relationship between ACEs and later psychiatric diagnoses, the researchers used data from the nationwide Swedish Twin Registry, which includes data on more than 25,000 identical and non-identical twins.

The Twin Registry is linked to the Swedish National Patient Register, which contains information on inpatient or outpatient psychiatric diagnoses after the age of 19.

The twins completed a large web-based questionnaire on depressive symptoms in the past week as a measure of current mental health and various types of ACEs, including family violence, emotional abuse or neglect, physical neglect, physical abuse, sexual abuse, rape, and hate crimes.

Three birth cohorts from the Twin Registry were surveyed between 2005 and 2016 and followed up in the national register from the age of 19 until the end of 2016.

In the sample of 25,000 twin pairs (15,000 women; average age at assessment: 29 years), 9,750 (39%) participants reported being exposed to at least one ACE, while 2,000 (8%) reported exposure to three or more ACEs. Most respondents – 61% – reported no ACE exposure.

Over 2300 participants received a psychiatric diagnosis as adults. The incidence of a psychiatric disorder increased from 503 individuals (6.4%) among participants without ACEs to 993 individuals (24.6%) among participants with three or more ACEs.

At the cohort level, a higher number of ACEs was dosedependently associated with an increased likelihood of a psychiatric disorder, the researchers found (Odds Ratio [OR], 1.52; 95% CI: 1.48–1.57).

Untangling Genes and Environment

To determine how much of the increased risk of mental illness in adults is attributable to ACEs and how much is due to genetics and environment, the researchers focused on twin pairs where one was exposed to a type of ACE and the other was not. This analysis revealed that the association persisted but was weakened. In identical twins, the effect of each ACE increased the likelihood of suffering from a psychiatric illness by 20% (1.20; 95% CI, 1.02–1.40), and in non-identical twins, the likelihood increased by 29% (1.29; 95% CI, 1.14-1.47).

The weakening of the risk „suggests that familial confounding factors contributed to the relationship between ACEs and the outcomes for adult mental health,“ the authors wrote.

Of all ACEs, sexual abuse poses the highest risk for psychiatric disorders in adults. Children exposed to sexual abuse had up to a 200% higher risk of psychiatric disorder in the following comparisons compared to children who were not exposed: total cohort (OR: 3.09; 95% CI: 2.68–3.56), dizygotic twin pairs (OR: 2.10; 95% CI: 1.33–3.32), and monozygotic twin pairs (1.80; 95% CI: 1.04–3.11).

„Our results showed that familial factors contributed to a lesser extent to the association between sexual abuse and psychiatric disorders in adults,“ the authors wrote.

A major limitation of the study was that ACEs were based on retrospective reports and therefore may be subject to recall bias. Additionally, the results may not be generalizable to other countries or cultures.

The study was funded by the European Research Council, the Icelandic Center for Research, and the European Union Horizon 2020. Disclosures are listed in the original article.

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