A Study On The Relationship Of Adverse Childhood Experience And Depressive Disorders Among Medical College Students In Anhui Province

Objective This study mainly examined the status and relationship of adverse childhood experience and lifetime and recent depressive disorders among medical college students ,so as to provide scientific evidence for future intervention measures .Methods 758 college medical students were chosen by stratified cluster sampling and investigated by an anonymous self-administrated questionnaire .Chi-square test ,Z test ,nonparametric test and logistic regression analysis were applied to analyze the prevalence of adverse childhood experience and lifetime and recent depressive disorders and their correlation . Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression models were used to assess the associations between each category of ACE and the risk of depressive disorders. The number of ACEs was summed for each respondent(range:0-10); analyses were repeated with five dichotomous variables (yes/no) with 0 ACEs as the referent. To test for observed trends in the ORs from the models using five dichotomous variables, the summed score was entered as an ordinal variable (0,1, 2, 3, 4, or≥5). We also modeled the relationship of the ACE score to depressive disorders with and without controlling for exposure to mental illness in the household.Results The prevalence of ACE was relevantly high among these students. Fifty-nine percent of respondents reported at least 1 of 10 categories. Over one of forth respondents reported at least 2 of the 10 categories. The highest prevalence belongs to physical abuse, secondly physical neglect. Both the prevalence of physical neglect and physical abuse were as high as nearly thirty percent. There was significant difference of the prevalence of ACE score among different habitation and gender and variant parental education degree (P<0.05).All 10 categories of ACEs were significantly associated with each of the others.The prevalence of lifetime and recent depressive disorders was 24.3%,12.1%,respectively, with the rate of female students being higher than that of male ones. Childhood emotional abuse increased risk for lifetime and recent depressive disorders, with adjusted odds ratios (ORs) of 3 and 4. Both the prevalence and risk(adjusted odds ratio) increased for lifetime and recent depressive disorders as ACE score increased. We found a strong, dose-response relationship between the ACE score and the probability of lifetime and recent depressive disorders. This relationship was attenuated slightly when a history of growing up with a mentally ill household member was included in the model, but remained significant.Conclusions The status of adverse childhood experience and lifetime and recent depressive disorders were serious. ACEs are strongly interrelated rather than occurring independently.A powerful graded relationship exists between adverse childhood experience and risk of lifetime and recent depressive disorders.More attention from school ,family and whole society should be paid to the study and prevention of adverse childhood experience and lifetime and recent depressive disorders.