Adverse childhood experiences and association with health, mental health, and risky behavior in the kingdom of Saudi Arabia

Background: The aim of this study is to determine if ACEs impact the health and risk behavior burden among Kingdom of Saudi Arabia (KSA) adults. Methods: In 2013, a cross-sectional study was conducted across KSA to identify the retrospective prevalence of ACEs and their association with high risk behaviors and chronic diseases. Surveys from 10,156 adults in all 13 Saudi regions were obtained using an Arabic version of the WHO ACE-IQ (KSA ACE-IQ). Results: Compared to respondents reporting no ACEs, even just one ACE contributed significantly to the odds of experiencing diabetes mellitus (OR = 1.3), depression (OR = 1.32), or anxiety (OR = 1.79) outcomes. Two ACEs were necessary for statistically significant, higher odds to emerge for hypertension (OR = 1.46), mental illness (OR = 1.93), smoking (OR = 1.17), alcohol use (OR = 1.75), and drug use (OR = 1.45). Respondents who reported four or more ACEs had greater odds of coronary heart disease (OR = 1.94), and obesity (OR = 2.25). Compared to those reporting no ACEs, respondents reporting four or more ACEs had over four times the odds of Alcohol or Drug Use, Mental Illness, Depression, and/or Anxiety outcomes and more than twice the odds of diabetes, hypertension, obesity, and/or smoking outcomes. Conclusion: Findings from this analysis underscore the potential benefit of providing focused preventative approaches to mitigating ACEs in KSA in relation to both the specific and cumulative burden of health and risky behavior outcomes. (C) 2016 Elsevier Ltd. All rights reserved.