Depressive symptoms mediate associations of adverse childhood experiences and chronic lung diseases: A mediation effect analysis

Abstract

Background: Adverse childhood experiences (ACEs) have been found to be related to the risk of chronic lung diseases (CLDs). However, the role of depressive symptoms (DS) in this link has not been fully examined. The present study aimed to explore the mediating effect of DS on the relationship between ACEs and CLDs.

Methods: Data for this retrospective cohort study were obtained from participants enrolled in the China Health and Retirement Longitudinal Study (CHARLS). To assess DS, the 10-item Center for Epidemiological Research Depression Scale was utilized. Logistic regression was employed to explore the associations between ACEs and DS, ACEs and CLDs, as well as depressive symptoms- chronic lung diseases (DS-CLDs). Mediation analysis was conducted to assess the mediating role of DS in the relationship between ACEs and CLDs.

Results: A total of 12,277 participants, comprising 5942 males and 6335 females, were included in this study. Logistic regression analysis identified associations between ACEs and the risk of DS, CLDs, and DS-CLDs. Mediating effect analysis demonstrated that DS had partial mediating effects on the association between CLDs and 7 ACEs, including feel alone, peer bullied, self-reported poor health status, health limitations, death of siblings, physical abuse, and parental mental health. Additionally, DS fully mediated the relationship between CLDs and hunger.

Conclusions: Our study establishes a significant association between ACEs and CLDs, as well as with DS and DS-CLDs in the elderly population. Furthermore, DS acts as a mediating factor in the ACEs and CLDs relationship.

Keywords: Adverse childhood experiences; Chronic lung diseases; Depression; Logistic regression; Mediating effect.