Adverse childhood experiences are defined as traumatic events until 17 years old and include physical, sexual or emotional abuse, domestic violence or living together with a family member with mental disease or suicidal attempt. It has been reported that adverse childhood experiences have a harmful effect on mental health. In addition, it is known that chronic diseases such as asthma also have a negative impact on mental health. However, it was yet to be reported whether there was a joint association of adverse childhood experiences and asthma with subsequent depressive symptom. Therefore, Mr. Yuta Takemura in the sixth grade at the faculty of medicine, Dr. Koryu Sato, Professor Naoki Kondo and Dr. Kosuke Inoue from Department of Social Epidemiology and Dr. Masanori Isobe from Department of Psychiatry, Kyoto University Graduate School of Medicine, and Dr. Richard Liang from Stanford University investigated the joint association between the adverse childhood experiences and asthma with subsequent depressive symptoms using marginal structural model to consider time-dependent confounders.
In their study, subjects were selected from data from the Behavioural Risk Factor Surveillance System 2010 released by CDC. 21,544 participants over 18 years old and living in the US were selected. Depending on the adverse childhood experiences and the history of asthma, the participants were classified into four groups. The authors adjusted for the background characteristics of subjects. In addition, they evaluated additive interaction between adverse childhood experiences and asthma using relative excess risk due to interaction as well as multiplicative interaction. Compared to the groups without the factors, adverse childhood experiences and asthma were associated with increase in subsequent depressive symptoms (ORs (95% CI) were 2.85 (2.30 to 3.55) and 2.24 (1.50 to 3.27), respectively). When participants had both adverse childhood experiences and history of asthma, OR for multiplicative interaction for depressive symptoms was 0.89 (0.59-1.44) and RERI was +1.63 (0.54-2.71).
This research revealed the additive interaction between adverse childhood experiences and history of asthma, suggesting that prevention and treatment of complications like asthma, along with preventing adverse childhood experiences, could play an important role in maintaining mental health for people with these experiences. Further studies on this topic are needed to specify concrete intervention in detail.
This study results were published online in the international journal, BMJ Mental Health on February 2nd, 2024.

Takemura Y, Sato K, Liang R, Isobe M, Kondo N, Inoue K. Estimating the joint association of adverse childhood experiences and asthma with subsequent depressive symptoms: a marginal structural modelling approach. BMJ Ment Health. 2024;27(1):e300859. Published 2024 Feb 2. doi:10.1136/bmjment-2023-300859

Corresponding to: inoue.kosuke.2j@kyoto-u.ac.jp
Link:https://mentalhealth.bmj.com/content/27/1/e300859