Effects of Adverse Childhood Experiences and Chronic Health Conditions on Current Depression

Purpose: The purpose of this study was to determine the independent and combined ability of three adverse childhood experience (ACE) types (household dysfunction, emotional/physical abuse, and sexual abuse) to predict current depression among adults. A second purpose was to determine the contribution of ACEs to depression scores after controlling for covariates and chronic illness. Method Adult respondents to the 2010 Behavioral Risk Factor Surveillance System (n = 20,345) were divided into currently depressed (n = 918) and not depressed (n = 19,427) groups based on Patient Health Questionnaire-8 (PHQ-8) scores. Binary logistic regression was used to determine the ability to predict current depression while controlling for effects of age, sex, marital status, employment, educational attainment, and number of chronic illnesses. Hierarchical multiple linear regression determined the effect of ACEs on PHQ-8 depression scores after accounting for the covariate set and chronic illnesses. Results Sexual Abuse has the strongest association with current depression of any single ACE (OR = 4.8, 95% CI = 2.1–10.8). The two-ACE combinations were generally as strongly associated with depression as sexual abuse alone. Experiencing all three ACEs confers the greatest increased risk of current depression (OR = 8.8, 95% CI = 5.6–13.8). Number of chronic illnesses account for about 2% of the variance in depression scores, while ACEs account for about 7% of the variance in current depression scores after controlling for covariates and chronic illness. Conclusions Self-reported adverse childhood experiences are significant predictors of current depression among adults after controlling for the effects of sociodemographic variables and chronic illness.