A history of adverse childhood experiences (ACE) is common among people with severe mental illness (SMI), and they are also associated with physical health problems, including metabolic syndrome (MetS) in general adult populations. We aimed to evaluate and synthesise the evidence relating to the association between ACE and MetS and/or its components in patients with SMI.
Methods
We systematically searched multiple databases (MEDLINE, PubMed, PsycINFO, EMBASE, Emcare, Cochrane Library, Health Technology Assessments, Joanna Briggs Institute, and Maternity and Infant Care database) and reviewed studies that described an association between ACE and MetS or its components in SMI adult patients.
Results
Twenty studies were reviewed. Most studies described a significant association between ACE and at least one to three components of MetS, with obesity being the most studied and, therefore, showing a more consistent association compared to the other MetS components. ACE and the components of MetS did not remain significant, in most of the studies, after adjusting for confounders. None of the studies showed an association with MetS as a whole entity.
Conclusion
Adults with SMI with a history of ACE are more likely to demonstrate health problems such as MetS and cardiovascular disease-related risk factors.
MisiakBPiotrowskiPBeszłejJA, et al.Metabolic Dysregulation and Psychosocial Stress in Patients with Schizophrenia Spectrum Disorders: A Case-Control Study. J Clin Med2020; 9(12): 3822.
2.
JakubowskiKPCundiffJMMatthewsKA. Cumulative childhood adversity and adult cardiometabolic disease: A meta-analysis. Health Psychol2018; 37(8): 701–715.
3.
WomersleyJSNothlingJToikumoS, et al.Childhood trauma, the stress response and metabolic syndrome: A focus on DNA methylation. Eur J Neurosci2022; 55: 2253–2296,
4.
BaumeisterDAkhtarRCiufoliniS, et al.Childhood trauma and adulthood inflammation: a meta-analysis of peripheral C-reactive protein, interleukin-6 and tumour necrosis factor-α. Mol Psychiatry2016; 21(5): 642–649.
5.
SoaresSRochaVKelly-IrvingM, et al.Adverse Childhood Events and Health Biomarkers: A Systematic Review. Front Public Health2021; 9: 649825. doi:10.3389/fpubh.2021.649825.
6.
González-DíazSNArias-CruzAElizondo-VillarrealB, et al.Psychoneuroimmunoendocrinology: clinical implications. World Allergy Organ J2017; 10(1): 19. doi: 10.1186/s40413-017-0151-6. PMID: 28616124; PMCID:
7.
YauYHCPotenzaMN. Stress and eating behaviors. Minerva Endocrinol2013; 38(3): 255–267.
8.
OsbornDPJWrightCALevyG, et al.Relative risk of diabetes, dyslipidaemia, hypertension and the metabolic syndrome in people with severe mental illnesses: systematic review and metaanalysis. BMC Psychiatry2008; 8: 84.
9.
BendallSJacksonHJHulbertCA, et al.Childhood trauma and psychotic disorders: a systematic, critical review of the evidence. Schizophr Bull2008; 34(3): 568–579.
10.
EvansTSBerkmanNBrownC, et al.Disparities Within Serious Mental Illness [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016. (Technical Briefs, No. 25.) Background. Available from:https://www.ncbi.nlm.nih.gov/books/NBK368430/.
11.
AasMDiesetIHopeS, et al.Childhood maltreatment severity is associated with elevated C-reactive protein and body mass index in adults with schizophrenia and bipolar diagnoses. Brain Behav Immun2017; 65: 342–349.
12.
AlamedaLLevierAGholam-RezaeeM, et al.Psychological trauma occurring during adolescence is associated with an increased risk of greater waist circumference in Early Psychosis patients treated with psychotropic medication. PLoS One2020; 15(12): e0242569.
13.
AlciatiAGesueleFRizziA, et al.Childhood parental loss and bipolar spectrum in obese bariatric surgery candidates. Int J Psychiatry Med2011; 41(2): 155–171.
14.
GodinOGaubeGOliéEFondaMental Advanced Centers of Expertise in Bipolar Disorders FACE-BD Collaborators, et al. Childhood maltreatment and metabolic syndrome in bipolar disorders: In search of moderators. Psychoneuroendocrinology2021; 131: 105327.
15.
GuenzelNHoufekJWatanabe-GallowayS. Adverse Events in Childhood as a Risk Factor for Elevated BMI among People with Schizophrenia and Bipolar Disorder. Issues Ment Health Nurs2016; 37(11): 829–838.
16.
HepgulNParianteCMDipasqualeS, et al.Childhood maltreatment is associated with increased body mass index and increased C-reactive protein levels in first-episode psychosis patients. Psychol Med2012; 42(9): 1893–1901.
17.
Jaworska-AndryszewskaPRybakowskiJK. Childhood adversity and clinical features of bipolar mood disorder. Archives of Psychiatry and Psychotherapy2018; 20: 13–19.
18.
KesebirSErdinçBTarhanN. Predictors of metabolic syndrome in first manic episode. Asian J Psychiatr2017; 25: 179–183.
19.
LeclercEMansurRBGrassi-OliveiraR, et al.The differential association between history of childhood sexual abuse and body mass index in early and late stages of bipolar disorder. J Affect Disord2018; 227: 214–218.
20.
LeeEEMartinASTuX, et al.Childhood Adversity and Schizophrenia: The Protective Role of Resilience in Mental and Physical Health and Metabolic Markers. J Clin Psychiatry2018; 79(3): 11776.
21.
LundingSHSimonsenCAasM, et al.Childhood trauma and cardiometabolic risk in severe mental disorders: The mediating role of cognitive control. Eur Psychiatry2021; 64(1): e24.
22.
McIntyreRSSoczynskaJKLiauwSS, et al.The association between childhood adversity and components of metabolic syndrome in adults with mood disorders: results from the international mood disorders collaborative project. Int J Psychiatry Med2012; 43(2): 165–177.
23.
MisiakBKiejnaAFrydeckaD. The history of childhood trauma is associated with lipid disturbances and blood pressure in adult first-episode schizophrenia patients. Gen Hosp Psychiatry2015; 37(4): 365–367.
24.
PostRMAltshulerLLLeverichGS, et al.Role of childhood adversity in the development of medical co-morbidities associated with bipolar disorder. J Affect Disord2013; 147(1–3): 288–294.
25.
RajkumarRP. The Impact of Childhood Adversity on the Clinical Features of Schizophrenia. Schizophr Res Treatment2015; 2015: 532082.
26.
ShahSMackinnonAGalletlyC, et al.Prevalence and impact of childhood abuse in people with a psychotic illness. Data from the second Australian National Survey of Psychosis. Schizophr Res2014; 159(1): 20–26.
27.
TosatoSBonettoCTomassiSGET UP GROUP, et al. Childhood trauma and glucose metabolism in patients with first-episode psychosis. Psychoneuroendocrinology2020; 113: 104536.
28.
Veru-LesmesFRhoAKingS, et al.Social Determinants of Health and Preclinical Glycemic Control in Newly Diagnosed First-Episode Psychosis Patients. Can J Psychiatry2018; 63(8): 547–556.
29.
YungEIskricAKrausG, et al.Childhood adversity and metabolic outcomes in adults with mood disorders. Comprehensive Psychiatry2014; 55: e58-e59.
30.
BernsteinDPSteinJANewcombMD, et al.Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl2003; 27(2): 169–190.
31.
NöthlingJMalan-MüllerSAbrahamsN, et al.Epigenetic alterations associated with childhood trauma and adult mental health outcomes: A systematic review. World J Biol Psychiatry2020; 21(7): 493–512.
32.
MariniSDavisKASoareTW, et al.Adversity exposure during sensitive periods predicts accelerated epigenetic aging in children.Psychoneuroendocrinology2020; 113: 104484. doi:10.1016/j.psyneuen.2019.104484.
33.
VareseFSmeetsFDrukkerM, et al.Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull2012; 38(4): 661–671.
34.
HuangHYanPShanZ, et al.Adverse childhood experiences and risk of type 2 diabetes: A systematic review and meta-analysis. Metabolism2015; 64(11): 1408–1418.
35.
HerzogJISchmahlC. Adverse Childhood Experiences and the Consequences on Neurobiological, Psychosocial, and Somatic Conditions Across the Lifespan. Front Psychiatry2018; 9: 420. doi:10.3389/fpsyt.2018.00420.
