From childhood struggles to adult strains: A systematic review of the impact of adverse childhood experiences on psycho-emotional functioning, pain outcomes, and quality of life in populations experiencing chronic pain.

Adverse childhood experiences (ACEs) are well-documented risk factors for later health problems, such as chronic pain and mental illness. We aimed to synthesise the impact of childhood trauma on psycho-emotional disorders, pain perception and cognitions, and quality of life in individuals with chronic pain. A systematic review was conducted following PRISMA guidelines for systematic reviews and meta-analyses. Eligible studies were identified by searching PubMed, PsychINFO, Embase, and Web of Science, with publication dates from 1988 to April 2023. Inclusion criteria were formulated according to the PECOS framework, and relevant research articles were screened for inclusion. Evidence from 18 studies highlights the significant impact of ACEs (and their typologies) on patients' psycho-emotional well-being, pain outcomes, and overall quality of life, with a cumulative effect emerging. However, significant methodological limitations, such as the lack of standardised measures to classify childhood adversity, prevent us from drawing definitive conclusions about the reported associations. The findings underscore the importance of integrated approaches to pain management that centre on the patient's life history and psycho-emotional status. Future research should address current limitations to strengthen our understanding of the role of ACEs in chronic pain research.