Cumulative Childhood Stress and Autoimmune Diseases in Adults

[Adminஐﻬ]

Cumulative Childhood Stress and Autoimmune Diseases in Adults

Methods:
 Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005. ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress. The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1) (e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia).

Results:
 Sixty-four percent reported at least one ACE. The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men. First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p < .05). Compared with persons with no ACEs, persons with 2 ACEs were at a 70% increased risk for hospitalizations with Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic diseases (p < .05).

Conclusions:
 Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses.

Key Words: childhood abuse • traumatic stress • autoimmune diseases • stress • inflammatory response


Abbreviations: ACE = adverse childhood experience; AD = autoimmune disease; Th1 = T-helper 1; Th2 = T-helper 2; CRP = C-reactive protein; CRH = corticoid releasing hormone.

SOURCE:
From National Center for Chronic Disease Prevention and Health Promotion (S.R.D., W.S.P. R.F.A., J.B.C.), Centers for Disease Control and Prevention, Division of Adult and Community Health, Atlanta, Georgia; Department of Environmental Health Sciences (D.F.), Bloomberg School of Public Health and Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland; and the Department of Preventive Medicine (V.J.F.), Southern California Permanente Medical Group (Kaiser Permanente), San Diego, California.