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Adverse childhood experiences, mental distress, and autoimmune disease in adult women: findings from two large cohort studies

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Title: Adverse childhood experiences, mental distress, and autoimmune disease in adult women: findings from two large cohort studies
Authors: Ole Köhler-Forsberg, Fenfen Ge, Thor Aspelund, Yue Wang, Fang Fang, Gunnar Tomasson, Edda Thordadottir, Arna Hauksdóttir, Huan Song, Unnur A. Valdimarsdottir
Source: Psychol Med
Köhler-Forsberg, O, Ge, F, Aspelund, T, Wang, Y, Fang, F, Tomasson, G, Thordadottir, E, Hauksdóttir, A, Song, H & Valdimarsdottir, U A 2025, 'Adverse childhood experiences, mental distress, and autoimmune disease in adult women : findings from two large cohort studies', Psychological Medicine, vol. 55, e36, pp. e36. https://doi.org/10.1017/S0033291724003544
Publisher Information: Cambridge University Press (CUP), 2025.
Publication Year: 2025
Subject Terms: Adult, Depression/epidemiology, Iceland, Adverse Childhood Experiences/statistics & numerical data, Anxiety, Psychological Distress, Autoimmune Diseases, Cohort Studies, Stress Disorders, Post-Traumatic, Autoimmune Diseases/epidemiology, Adverse Childhood Experiences, Prevalence, Humans, autoimmune diseases, mediation, Iceland/epidemiology, Aged, Stress, Psychological/epidemiology, United Kingdom/epidemiology, Depression, PTSD, Middle Aged, anxiety, United Kingdom, Stress Disorders, Post-Traumatic/epidemiology, Cross-Sectional Studies, depression, Original Article, Female, adverse childhood experiences, Anxiety/epidemiology, Stress, Psychological
Description: Background Adverse childhood experiences (ACEs) have been associated with increased risks of autoimmune diseases. However, data are scarce on the role of specific ACEs as well as the potential mediating role of adverse mental health symptoms in this association. Methods A cohort study using the nationwide Icelandic Stress-And-Gene-Analysis (SAGA, 22,423 women) cohort and the UK Biobank (UKB, 86,492 women) was conducted. Participants self-reported on five ACEs. Twelve autoimmune diseases were self-reported in SAGA and identified via hospital records in UKB. Poisson regression was used to assess the cross-sectional association between ACEs and autoimmune diseases in both cohorts. Using longitudinal data on self-reported mental health symptoms in the UKB, we used causal mediation analyses to study potential mediation by depressive, anxiety, and PTSD symptoms in the association between ACEs and autoimmune diseases. Results The prevalence of ACEs was 50% in SAGA and 35% in UKB, while the prevalence of autoimmune diseases was 29% (self-reported) and 14% (clinically confirmed), respectively. In both cohorts, ACEs were associated with an increased prevalence ratio (PR) of any studied autoimmune disease in a dose–response manner (PR = 1.10 (95%CI = 1.08–1.12) per ACE), particularly for Sjögrens (PR = 1.34), polymyalgia rheumatica (PR = 1.20), rheumatoid arthritis (PR = 1.14), systemic lupus erythematosus (PR = 1.13), and thyroid disease (PR = 1.11). Sexual abuse and physical and emotional neglect were consistently associated with an elevated prevalence of autoimmune diseases when including all ACEs in the model. Approximately one fourth of the association was mediated through depression, anxiety, and PTSD. Conclusions These findings based on two large cohorts indicate a role of ACEs and corresponding mental health distress in autoimmune diseases among adult women.
Document Type: Article
Other literature type
Language: English
ISSN: 1469-8978
0033-2917
DOI: 10.1017/s0033291724003544
Access URL: https://pubmed.ncbi.nlm.nih.gov/39930807
http://www.scopus.com/inward/record.url?scp=85218437075&partnerID=8YFLogxK
https://doi.org/10.1017/S0033291724003544
https://pure.au.dk/portal/en/publications/e52c7d4e-9989-422a-a304-3cde963ed7e7
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Accession Number: edsair.doi.dedup.....acee9e843c6db9e334e03c908e3bea53
Database: OpenAIRE
Description
Abstract:Background Adverse childhood experiences (ACEs) have been associated with increased risks of autoimmune diseases. However, data are scarce on the role of specific ACEs as well as the potential mediating role of adverse mental health symptoms in this association. Methods A cohort study using the nationwide Icelandic Stress-And-Gene-Analysis (SAGA, 22,423 women) cohort and the UK Biobank (UKB, 86,492 women) was conducted. Participants self-reported on five ACEs. Twelve autoimmune diseases were self-reported in SAGA and identified via hospital records in UKB. Poisson regression was used to assess the cross-sectional association between ACEs and autoimmune diseases in both cohorts. Using longitudinal data on self-reported mental health symptoms in the UKB, we used causal mediation analyses to study potential mediation by depressive, anxiety, and PTSD symptoms in the association between ACEs and autoimmune diseases. Results The prevalence of ACEs was 50% in SAGA and 35% in UKB, while the prevalence of autoimmune diseases was 29% (self-reported) and 14% (clinically confirmed), respectively. In both cohorts, ACEs were associated with an increased prevalence ratio (PR) of any studied autoimmune disease in a dose–response manner (PR = 1.10 (95%CI = 1.08–1.12) per ACE), particularly for Sjögrens (PR = 1.34), polymyalgia rheumatica (PR = 1.20), rheumatoid arthritis (PR = 1.14), systemic lupus erythematosus (PR = 1.13), and thyroid disease (PR = 1.11). Sexual abuse and physical and emotional neglect were consistently associated with an elevated prevalence of autoimmune diseases when including all ACEs in the model. Approximately one fourth of the association was mediated through depression, anxiety, and PTSD. Conclusions These findings based on two large cohorts indicate a role of ACEs and corresponding mental health distress in autoimmune diseases among adult women.
ISSN:14698978
00332917
DOI:10.1017/s0033291724003544