Adverse Childhood Experiences (ACE) in outpatients with anxiety and depressive disorders and their association with psychiatric and somatic comorbidity and revictimization. Cross-sectional observational study

Background: This study aims to establish prevalence of Adverse Childhood Experiences (ACE) and their association with somatic comorbidity and adult adverse events (AAE) in outpatients with anxiety or depressive disorders. Methods: Cross-sectional observational design. Specialty mental health outpatients classified with DSM-IV-TR anxiety or depressive disorder filled-out the ACE-IQ and the AAE-IQ. T-tests, ANOVA, logistic regressions and Chi-square analyses were performed and stratified for ACE score >= 4(high) versus ACE < 4(low). Gender differences were explored. Results: From May 2015 -November 2016, in 298 consecutive patients 77.2% reported at least one ACE, 58.7% reported multiple ACE (mean 2.92). Scores were highest in Post-Traumatic Stress Disorder (PTSD) and in case of comorbid mental disorders. Somatic comorbidity was not associated with ACE-scores. AAE scores were significantly (t=-9.33, p < .001) higher in the high ACE-group (M = 4.09 SD = 2.42) versus the low-ACE group (M = 1.63 SD = 1.70), indicating general revictimization. An association between sexual ACE and sexual revictimization was found as well (chi 2 = 86.14, p < .001). The effects did not differ for males and females. Conclusions: ACE and AAE are highly prevalent in depressive and anxiety disorders PTSD and psychiatric comorbidity are associated with higher scores, somatic comorbidity is not. Indications for general and sexual revictimization are shown. Further research is needed. Limitations: Selection bias may have influenced results on somatic comorbidity, as patients with obvious somatic comorbidity usually get referred to other health services. The generalisability of the results may be limited as non-Dutch speaking immigrants were excluded.