Cumulative Exposure to Adverse Childhood Experience: Depressive Symptoms, Suicide Intensions and Suicide Plans among Senior High School Students in Nanchang City of China

This study tested relationships between different types of adverse childhood experiences (ACE) and depressive symptoms, suicide intensions, suicide plans and examines the cumulative effects of adverse childhood experience on depressive, suicide intentions and suicide plans among senior high school students. We conducted a survey among five senior high schools in Nanchang city, which were selected through stratified random cluster sampling. Among the 884 respondents, 409 were male (46.27%), and 475 were female (53.73%); the age ranged from 14 to 18. During the past 12 months, 199 (22.51%) students presented to depressive symptoms, 125 (14.14%) students had suicide intensions, 55 (6.22%) students had suicide plans. As ACE scores increased, there was an increase in the odds of (1) depressive symptoms-one ACE (adjusted odds ratio, AOR = 2.096,p< 0.001), two ACEs (AOR = 3.155,p< 0.001) and three to five ACEs (AOR = 9.707,p< 0.001); suicide intensions-1 ACE (AOR = 1.831,p= 0.011), two ACEs (AOR = 2.632,p= 0.002) and three to five ACEs (AOR = 10.836,p< 0.001); and (2) suicide plans-one ACE (AOR = 2.599,p< 0.001), two ACEs (AOR = 4.748,p< 0.001) and three to five ACEs (AOR = 22.660,p< 0.001). We should increase the awareness of adolescents who have had adverse childhood experience, especially those with multiple ACEs to prevent depression and suicide among senior high school students.