Using phenome-wide association studies and the SF-12 quality of life metric to identify profound consequences of adverse childhood experiences on adult mental and physical health in a northern Nevadan population

In this research, we examine and identify the implications of Adverse Childhood Experiences (ACEs) on a range of health outcomes, with particular focus on a number of mental health disorders. Many previous studies observed that traumatic childhood events are linked to long-term adult diseases using the standard Adverse Childhood Experience Questionnaire. The study cohort was derived from the Healthy Nevada Project, a volunteer-based population health study in which each adult participant is invited to take a retrospective questionnaire that includes the Adverse Childhood Experience Questionnaire, the 12-item Short Form Survey measuring quality of life, and self-reported incidence of nine mental disorders. Using participants' cross-referenced electronic health records, a phenome-wide association analysis of 1,703 phenotypes and the incidence of ACEs examined links between traumatic events in childhood and adult disease. These analyses showed that many mental disorders were significantly associated with ACEs in a dose-response manner. Similarly, a dose-response between ACEs and obesity, chronic pain, migraine, and other physical phenotypes was identified. An examination of the prevalence of self-reported mental disorders and incidence of ACEs showed a positive relationship. Furthermore, participants with less adverse childhood events experienced a higher quality of life, both physically and mentally. The whole-phenotype approach confirms that ACEs are linked with many negative adult physical and mental health outcomes. With the nationwide prevalence of ACEs as high as 67%, these findings suggest a need for new public health resources: ACE-specific interventions and early childhood screenings.

本研究旨在探究并明确儿童期不良经历（Adverse Childhood Experiences，ACEs）对一系列健康结局的影响，尤其聚焦于多种精神障碍。既往多项研究已通过标准化儿童期不良经历问卷证实，童年创伤事件与成人长期慢性疾病存在关联。本研究的队列数据来源于健康内华达项目（Healthy Nevada Project）——一项基于志愿者的人群健康研究，所有成年参与者均需填写回顾性问卷，问卷内容涵盖儿童期不良经历问卷、用于评估生活质量的12条目简明健康调查量表，以及9种精神障碍的自我报告发病率。本研究依托参与者的交叉验证电子健康档案，针对1703个表型与儿童期不良经历发生率开展表型组全关联分析，以此探究童年创伤事件与成人疾病之间的关联。上述分析结果显示，多种精神障碍与儿童期不良经历呈显著的剂量-反应关系。同理，本研究亦发现儿童期不良经历与肥胖、慢性疼痛、偏头痛及其他躯体表型之间同样存在剂量-反应关联。对自我报告的精神障碍患病率与儿童期不良经历发生率的分析显示二者呈正相关关系。此外，童年不良经历越少的参与者，其躯体与精神生活质量均越高。全表型组分析方法证实，儿童期不良经历与诸多成人期不良躯体及精神健康结局存在关联。鉴于全美儿童期不良经历的患病率高达67%，本研究结果提示亟需针对性的公共卫生资源投入：即针对儿童期不良经历的干预措施与童年早期筛查方案。