Projects per year
Abstract
Background
Adverse childhood experiences (ACEs) have been implicated in the aetiology of a range of health outcomes, including multimorbidity. In this systematic review and meta-analysis, we aimed to identify, synthesise,and quantify the current evidence linking ACEs and multimorbidity.
Methods
We searched seven databases from inception to 20 July 2023: APA PsycNET, CINAHL Plus, Cochrane CENTRAL,Embase, MEDLINE, Scopus, and Web of Science. We selected studies investigating adverse events occurring duringchildhood (< 18 years) and an assessment of multimorbidity in adulthood (≥ 18 years). Studies that only assessedadverse events in adulthood or health outcomes in children were excluded. Risk of bias was assessed using the ROBINS-E tool. Meta-analysis of prevalence and dose–response meta-analysis methods were used for quantitative datasynthesis. This review was pre-registered with PROSPERO (CRD42023389528).
Results
From 15,586 records, 25 studies were eligible for inclusion (total participants = 372,162). The prevalenceof exposure to ≥ 1 ACEs was 48.1% (95% CI 33.4 to 63.1%). The prevalence of multimorbidity was 34.5% (95% CI 23.4to 47.5%). Eight studies provided sufficient data for dose–response meta-analysis (total participants = 197,981). Therewas a significant dose-dependent relationship between ACE exposure and multimorbidity (p < 0.001), with everyadditional ACE exposure contributing to a 12.9% (95% CI 7.9 to 17.9%) increase in the odds for multimorbidity. However,there was heterogeneity among the included studies (I2 = 76.9%, Cochran Q = 102, p < 0.001).
Conclusions
This is the first systematic review and meta-analysis to synthesise the literature on ACEs and multimorbidity,showing a dose-dependent relationship across a large number of participants. It consolidates and enhancesan extensive body of literature that shows an association between ACEs and individual long-term health conditions,risky health behaviours, and other poor health outcomes.
Adverse childhood experiences (ACEs) have been implicated in the aetiology of a range of health outcomes, including multimorbidity. In this systematic review and meta-analysis, we aimed to identify, synthesise,and quantify the current evidence linking ACEs and multimorbidity.
Methods
We searched seven databases from inception to 20 July 2023: APA PsycNET, CINAHL Plus, Cochrane CENTRAL,Embase, MEDLINE, Scopus, and Web of Science. We selected studies investigating adverse events occurring duringchildhood (< 18 years) and an assessment of multimorbidity in adulthood (≥ 18 years). Studies that only assessedadverse events in adulthood or health outcomes in children were excluded. Risk of bias was assessed using the ROBINS-E tool. Meta-analysis of prevalence and dose–response meta-analysis methods were used for quantitative datasynthesis. This review was pre-registered with PROSPERO (CRD42023389528).
Results
From 15,586 records, 25 studies were eligible for inclusion (total participants = 372,162). The prevalenceof exposure to ≥ 1 ACEs was 48.1% (95% CI 33.4 to 63.1%). The prevalence of multimorbidity was 34.5% (95% CI 23.4to 47.5%). Eight studies provided sufficient data for dose–response meta-analysis (total participants = 197,981). Therewas a significant dose-dependent relationship between ACE exposure and multimorbidity (p < 0.001), with everyadditional ACE exposure contributing to a 12.9% (95% CI 7.9 to 17.9%) increase in the odds for multimorbidity. However,there was heterogeneity among the included studies (I2 = 76.9%, Cochran Q = 102, p < 0.001).
Conclusions
This is the first systematic review and meta-analysis to synthesise the literature on ACEs and multimorbidity,showing a dose-dependent relationship across a large number of participants. It consolidates and enhancesan extensive body of literature that shows an association between ACEs and individual long-term health conditions,risky health behaviours, and other poor health outcomes.
| Original language | English |
|---|---|
| Article number | 315 |
| Number of pages | 14 |
| Journal | BMC Medicine |
| Volume | 22 |
| DOIs | |
| Publication status | Published - 15 Aug 2024 |
Keywords
- Adverse childhood experiences
- Childhood adversity
- Chronic disease
- Long-term conditions
- Multimorbidity
Fingerprint
Dive into the research topics of 'The impact of adverse childhood experiences on multimorbidity: a systematic review and meta-analysis'. Together they form a unique fingerprint.Projects
- 3 Active
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Adverse Childhood Experiences: Understanding the Impact on Multimorbidity in Adulthood, a Focus on Chronic Pain, Addiction and Mental Health (Wellcome Trust Clinical PhD Fellowship)
Colvin, L. (Investigator) & Smith, B. (Investigator)
1/11/22 → 31/10/25
Project: Research
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Partnership for Assessment and Investigation of Neuropathic Pain: Studies Tracking Outcomes, Risks and Mechanisms (PAINSTORM) - (Joint with Universities of Oxford, Ghent and Aberdeen, Imperial College London and King's College London) (Advanced Pain Discovery Platform)
Colvin, L. (Investigator), Smith, B. (Investigator), Steele, D. (Investigator) & Veluchamy, A. (Investigator)
14/07/21 → 13/07/26
Project: Research
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Consortium Against Pain InEquality (CAPE) - The Impact of Adverse Childhood Experiences on Chronic Pain and Responses to Treatment (Joint with University of Aberdeen, University of Edinburgh, University of Stirling and University College, London) (Advanced Pain Discovery Platform)
Brown, A. (Investigator), Colvin, L. (Investigator), Hales, T. (Investigator) & Steele, D. (Investigator)
1/07/21 → 30/06/26
Project: Research
Press/Media
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Impact of adverse childhood experiences on multimorbidity
16/08/24
1 Media contribution
Press/Media: Research
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Study finds trauma in childhood increases risk of health conditions later in life
15/08/24
1 Media contribution
Press/Media: Research