Author Of 1 Presentation
P0429 - Adverse childhood experiences and psychiatric comorbidity in multiple sclerosis and other immune mediated inflammatory disorders (ID 1252)
Abstract
Background
Adverse childhood experiences (ACE) encompass abuse, neglect and household dysfunction, such as parental divorce or mental illness, in early life. ACE may increase the risk of adverse physical and psychiatric health outcomes. A prior study showed an association between multiple sclerosis (MS) and ACE, but the impact of ACE on psychiatric comorbidity in MS and other immune-mediated inflammatory diseases (IMID) is not well-characterized.
Objectives
To determine whether ACE, specifically abuse and neglect, are associated with MS and other IMID, including inflammatory bowel disease (IBD) and rheumatoid arthritis (RA). We further aimed to determine the relationship between ACE and psychiatric comorbidity in the IMID population and whether these relationships differed between MS and other IMID.
Methods
There were 925 adult participants in this study, across five cohorts (MS: 232, IBD: 216, RA: 130, anxiety and depression [ANX/DEP]: 244, healthy control: 103). A structured psychiatric interview was used to identify psychiatric disorders. The validated Childhood Trauma Questionnaire was used to evaluate five types of ACE: emotional abuse (EA), physical abuse, sexual abuse, emotional neglect and physical neglect. We evaluated associations between ACE, IMID and psychiatric comorbidity using multivariable binary and ordinal logistic regression models.
Results
Overall, 66.2% of the participants had ≥1 category of ACE. Prevalence of ACE was similar across IMID groups, but higher than in healthy controls (MS: 63.8%, IBD: 61.6%, RA: 62.3%, ANX/DEP: 83.2%, control: 45.6%). Only EA was associated with increased odds of having an IMID (adjusted odds ratio [aOR] 2.37; 1.15-4.89). Presence of any ACE was associated with psychiatric comorbidity in the IMID cohort (OR 2.24; 1.58-3.16), but this association did not differ among MS, IBD and RA. Furthermore, in those with IMID, total number of ACE (aOR 1.36; 1.17-1.59) and EA (aOR 2.64; 1.66-4.21) were independently associated with increased odds of psychiatric comorbidity.
Conclusions
A history of ACE is more common in MS and other IMID than in a healthy population. ACE is associated with psychiatric comorbidity in IMID populations. Given the high burden of psychiatric disorders in the MS population, clinicians should be aware of the possible contribution of ACE, and the potential need for trauma-informed care strategies in these patients.
Presenter Of 1 Presentation
P0429 - Adverse childhood experiences and psychiatric comorbidity in multiple sclerosis and other immune mediated inflammatory disorders (ID 1252)
Abstract
Background
Adverse childhood experiences (ACE) encompass abuse, neglect and household dysfunction, such as parental divorce or mental illness, in early life. ACE may increase the risk of adverse physical and psychiatric health outcomes. A prior study showed an association between multiple sclerosis (MS) and ACE, but the impact of ACE on psychiatric comorbidity in MS and other immune-mediated inflammatory diseases (IMID) is not well-characterized.
Objectives
To determine whether ACE, specifically abuse and neglect, are associated with MS and other IMID, including inflammatory bowel disease (IBD) and rheumatoid arthritis (RA). We further aimed to determine the relationship between ACE and psychiatric comorbidity in the IMID population and whether these relationships differed between MS and other IMID.
Methods
There were 925 adult participants in this study, across five cohorts (MS: 232, IBD: 216, RA: 130, anxiety and depression [ANX/DEP]: 244, healthy control: 103). A structured psychiatric interview was used to identify psychiatric disorders. The validated Childhood Trauma Questionnaire was used to evaluate five types of ACE: emotional abuse (EA), physical abuse, sexual abuse, emotional neglect and physical neglect. We evaluated associations between ACE, IMID and psychiatric comorbidity using multivariable binary and ordinal logistic regression models.
Results
Overall, 66.2% of the participants had ≥1 category of ACE. Prevalence of ACE was similar across IMID groups, but higher than in healthy controls (MS: 63.8%, IBD: 61.6%, RA: 62.3%, ANX/DEP: 83.2%, control: 45.6%). Only EA was associated with increased odds of having an IMID (adjusted odds ratio [aOR] 2.37; 1.15-4.89). Presence of any ACE was associated with psychiatric comorbidity in the IMID cohort (OR 2.24; 1.58-3.16), but this association did not differ among MS, IBD and RA. Furthermore, in those with IMID, total number of ACE (aOR 1.36; 1.17-1.59) and EA (aOR 2.64; 1.66-4.21) were independently associated with increased odds of psychiatric comorbidity.
Conclusions
A history of ACE is more common in MS and other IMID than in a healthy population. ACE is associated with psychiatric comorbidity in IMID populations. Given the high burden of psychiatric disorders in the MS population, clinicians should be aware of the possible contribution of ACE, and the potential need for trauma-informed care strategies in these patients.