Variety ACEs and risk of developing anxiety, depression, or anxiety-depression co-morbidity: the 2006-2022 UK Biobank data

Peilin Yu; Zhou Jiang; Chu Zheng; Ping Zeng; Lihong Huang; Yingliang Jin; Ke Wang

doi:10.3389/fpsyt.2023.1233981

Variety ACEs and risk of developing anxiety, depression, or anxiety-depression co-morbidity: the 2006-2022 UK Biobank data

Front Psychiatry. 2023 Dec 27:14:1233981. doi: 10.3389/fpsyt.2023.1233981. eCollection 2023.

Authors

Peilin Yu¹, Zhou Jiang¹, Chu Zheng^{1

2

3

4

5}, Ping Zeng^{1

2

3

4

5}, Lihong Huang⁶, Yingliang Jin^{1

2

3

4

5}, Ke Wang^{1

2

3

4

5}

Affiliations

¹ Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China.
² Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China.
³ Key Lab of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu, China.
⁴ Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, China.
⁵ Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu, China.
⁶ Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, China.

Abstract

Objectives: Adverse childhood experiences (ACEs) and anxiety-depression co-morbidity are attracting widespread attention. Previous studies have shown the relationship between individual psychiatric disorders and ACEs. This study will analyze the correlation between anxiety-depression co-morbidity and different levels of ACEs.

Methods: Seven categories of ACE and four classifications of psychiatric disorders were defined in a sample of 126,064 participants identified by the UK Biobank from 2006-2022, and correlations were investigated using logistic regression models. Then, to explore nonlinear relationships, restricted spline models were developed to examine differences in sex and age across cohorts (n = 126,064 for the full cohort and n = 121,934 for the European cohort). Finally, the impact of the category of ACEs on psychiatric disorders was examined.

Results: After controlling for confounders, ACEs scores showed dose-dependent relationships with depression, anxiety, anxiety-depression co-morbidity, and at least one (any of the first three outcomes) in all models. ACEs with different scores were significantly positively correlated with the four psychiatric disorders classifications, with the highest odds of anxiety-depression co-morbidity (odds ratio [OR] = 4.87, 95% confidence intervals [CI]: 4.37 ~ 5.43), p = 6.08 × 10^-178. In the restricted cubic spline models, the risk was relatively flat for females at ACEs = 0-1 and males at ACEs = 0-2/3 (except in males, where ACEs were associated with a lower risk of anxiety, all other psychiatric disorders had an increased risk of morbidity after risk smoothing). In addition, the risk of having anxiety, depression, anxiety-depression co-morbidity, and at least one of these disorders varies with each category of ACEs.

Conclusion: The prevalence of anxiety-depression comorbidity was highest across ACE scores after controlling for confounding factors and had a significant effect on each category of ACEs.

Keywords: ACEs; UK Biobank; anxiety-depression co-morbidity; restricted cubic spline; sex.

Grants and funding

WT_/Wellcome Trust/United Kingdom