Associations between adverse childhood experiences and overweight, obese, smoking and binge drinking among adult patients with depression in China

This study aimed to examine the prevalence of health outcomes and its associations with adverse childhood experiences (ACEs) in patients with depression. A total of 562 inpatients with depression who met the inclusion criteria were consecutively screened. All enrolled patients completed a series of assessments, including demographic information, ACEs, height and weight used to calculate body mass index (BMI), smoking, and binge drinking. The prevalence of overweight, obese, smoking and binge drinking in the whole sample was 24.3%, 3.1%, 15.7% and 23.7%, respectively. Overweight/obese were associated with physical abuse (OR = 2.793, 95%CI = 1.620-4.815, P < 0.001), emotional abuse (OR = 3.073, 95%CI = 1.796-5.259, P < 0.001; obese-OR = 11.587, 95%CI = 2.729-49.196, P = 0.001), emotional neglect (OR = 4.021, 95%CI = 2.313-6.992, P < 0.001), caregiver divorce/family separation (OR = 2.676, 95%CI = 1.626-4.404, P < 0.001; obese-OR = 5.100, 95%CI = 1.680-15.479, P = 0.004) and caregiver treated violently (OR = 2.304, 95%CI = 1.383-3.837, P = 0.001). Smoking were associated with physical abuse (OR = 2.756, 95%CI = 1.432-5.304, P = 0.002), emotional abuse (OR = 2.811, 95%CI = 1.499-5.270, P = 0.001), physical neglect (OR = 2.901, 95%CI = 1.504-5.596, P = 0.001), sexual abuse (OR = 2.389, 95%CI = 1.310-4.357, P = 0.005) and caregiver incarceration (OR = 2.798, 95%CI = 1.151-6.756, P = 0.023). While physical abuse (OR = 3.164, 95%CI = 1.835-5.454, P < 0.001), emotional abuse (OR = 2.625, 95%CI = 1.529-4.508, P < 0.001), emotional neglect (OR = 2.195, 95%CI = 1.287-3.743, P = 0.004), sexual abuse (OR = 2.453, 95%CI = 1.406-4.280, P = 0.002), caregiver mental illness (OR = 2.004, 95%CI = 1.186-3.386, P = 0.009) and caregiver divorce/family separation (OR = 2.411, 95%CI = 1.481-3.926, P < 0.001)-emerged as significant correlates of binge drinking. And patients who exposed to more types of ACEs showed a higher odds of overweight/obese, smoking and binge drinking compared with patients who have not been exposed to any type ACE. The associations between ACEs and health outcomes should not only consider its potential physiological mechanism, but also consider the emotional characteristics of patients with depression, social and family factors. Besides, standardized screening of ACEs in line with Chinese culture, intervention programs to improve family environment, collaborative and traumatic information services throughout the life cycle may reduce the negative impact of ACEs on patients with depression, and then reduce the risk of health outcomes.