Association of adverse childhood experiences with the development of multiple sclerosis

Abstract

ObjectiveTo study whether exposure to childhood emotional, sexual or physical abuse is associated with subsequent multiple sclerosis (MS) development.MethodsA nationwide, prospective cohort study based on participants in the Norwegian Mother, Father and Child cohort study. Enrolment took place 1999–2008, with follow-up until 31 December 2018. Childhood abuse before age 18 years was obtained from self-completed questionnaires. We identified MS diagnoses through data-linkage with national health registries and hospital records. The Cox model was used to estimate HRs for MS with 95% CIs, adjusting for confounders and mediators.ResultsIn this prospective cohort study, 14 477 women were exposed to childhood abuse and 63 520 were unexposed. 300 women developed MS during the follow-up period. 71 of these (24%) reported a history of childhood abuse, compared with 14 406 of 77 697 (19%) women that did not develop MS. Sexual abuse (HR 1.65, 95% CI 1.13 to 2.39) and emotional abuse (HR 1.40, 95% CI 1.03 to 1.90) in childhood were both associated with an increased risk of developing MS. The HR of MS after exposure to physical abuse was 1.31 (95% CI 0.83 to 2.06). The risk of MS was further increased if exposed to two (HR 1.66, 95% CI 1.04 to 2.67) or all three abuse categories (HR 1.93, 95% CI 1.02 to 3.67).InterpretationChildhood sexual and emotional abuse were associated with an increased risk of developing MS. The risk was higher when exposed to several abuse categories, indicating a dose–response relationship. Further studies are needed to identify underlying mechanisms.

Association of adverse childhood experiences with adulthood multiple sclerosis: A systematic review of observational studies

“…Further, 69 articles were removed that did not meet the inclusion criteria of the review. Eventually, a total of 11 studies were included for qualitative synthesis, which included 6 case‐control studies (Spitzer et al., 2012; Horton et al., 2022; Briones‐Buixassa et al., 2019; Eftekharian et al., 2016; Gunnarsson et al., 2015; Warren et al., 1982), 3 retrospective cohort studies (Shaw et al., 2017; Nielsen et al., 2014; Pust et al., 2020), and 2 prospective cohorts (Eilam‐Stock et al., 2021; Eid et al., 2022). Study characteristics and baseline characteristics of participants are provided in Tables 1 and 2, respectively.…”

“…This systematic review included 2 prospective cohort studies (Eilam‐Stock et al., 2021; Eid et al., 2022), 3 retrospective studies (Shaw et al., 2017; Nielsen et al., 2014; Pust et al., 2020), and 6 case‐control studies (Spitzer et al., 2012; Horton et al., 2022; Briones‐Buixassa et al., 2019; Eftekharian et al., 2016; Gunnarsson et al., 2015; Warren et al., 1982). In contrast to case‐control studies that identify the study subjects based on the outcome status, prospective cohort studies identify exposure prior to the outcome and comprise the framework for assessing causality.…”

“…Since ACEs are also associated with immune dysregulation, increasing number of studies are supporting an association between ACEs and some autoimmune diseases (DeQuattro et al., 2020; Dube et al., 2009; Eilam‐Stock et al., 2021; Luiz et al., 2018). Many of the studies focus particularly on the association between ACEs and MS (Eilam‐Stock et al., 2021; Eid et al., 2022; Horton et al., 2022); however, the evidence relies substantially on cross‐sectional designs. Hence the present review aims to get an overview of all the published studies that interlink the ACEs to adult life MS.…”

Adverse childhood experiences and the development of Down syndrome regression disorder

“…The temporal association between stressors and symptom onset in many individuals with DSRD is a justification for primary psychiatric/psychologic diagnosis and trial of therapeutics such as antidepressants, antipsychotics, and in severe cases, electroconvulsive therapy (Santoro, Baumer, et al, 2022; Santoro, Partridge, et al, 2022). However, the interface of stressors and immune dysregulation, an emerging cause of DSRD (Santoro, Partridge, et al, 2022) is under‐recognized and may be a unifying link among individuals with this symptom cluster (Dube et al, 2009; Eid et al, 2022). To date, there have been no large‐scale, controlled, studies evaluating the role of environmental stressors in the development of DSRD.…”

Abuse and revictimization in adulthood in multiple sclerosis: a cross-sectional study during pregnancy

“…People with multiple sclerosis (MS) are more often exposed to abuse and neglect in childhood than the general population [1][2][3][4]. Mistreatment in childhood is a strong predictor of abuse later in life, known as revictimization [5].…”