The relationship between adverse childhood experiences and common mental disorders among pregnant women living with HIV in Malawi.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 09 2022
Historique:
received: 25 11 2021
revised: 28 05 2022
accepted: 16 06 2022
pubmed: 26 6 2022
medline: 12 7 2022
entrez: 25 6 2022
Statut: ppublish

Résumé

Adverse childhood experiences (ACEs) have been linked to common mental disorders (CMDs) such as anxiety and depressive thoughts. We examined the prevalence of ACEs and their association with CMDs among pregnant women living with HIV (PWLHIV) in Malawi-an HIV endemic resource-limited setting. This is a cross-sectional study of 798 PWLHIV enrolled in the VITAL Start trial in Malawi (10/2018 to 06/2021) (NCT03654898). ACE histories were assessed using WHO's Adverse Childhood Experiences International Questionnaire (ACE-IQ) tool. Depressive symptoms (somatic complaints, reduced vital energy, anxiety, and depressive thoughts) were assessed using WHO's Self Reporting Questionnaire 20-Item (SRQ-20) tool. Log-binomial regressions were used to examine the association between cumulative ACEs and each depressive symptom, as well as identify ACEs driving this association. The mean age of our sample was 27.5 years. Over 95 % reported having experienced ≥1 ACE. On average, each participant reported four ACEs; 11 % reported sexual abuse. About 52 % and 44 % reported anxiety and depressive thoughts, respectively. In regressions, cumulative ACE scores were significantly associated with depressive symptoms-even after adjusting for multiple testing. This association was primarily driven by reports of sexual abuse. Data on maternal ACEs were self-reported and could suffer from measurement error because of recall bias. ACEs are widespread and have a graded relationship with depressive symptoms in motherhood. Sexual abuse was found to be a primary driver of this association. Earlier recognition of ACEs and provision of trauma-informed interventions to improve care in PWLHIV may reduce negative mental health sequelae.

Identifiants

pubmed: 35752220
pii: S0165-0327(22)00687-5
doi: 10.1016/j.jad.2022.06.028
pmc: PMC9892657
mid: NIHMS1865108
pii:
doi:

Types de publication

Clinical Trial Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

159-168

Subventions

Organisme : NICHD NIH HHS
ID : K12 HD052023
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH115793
Pays : United States

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

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Auteurs

Steven P Masiano (SP)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi; Healthcare Delivery and Implementation Science Center, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: masians@ccf.org.

Xiaoying Yu (X)

Department of Biostatistics & Data Science, School of Public Health and Population Health, University of Texas Medical Branch, Galveston, TX, USA.

Tapiwa Tembo (T)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.

Elizabeth Wetzel (E)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi; Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.

Mtisunge Mphande (M)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.

Innocent Khama (I)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.

Angella Mkandawire (A)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.

Mike Chitani (M)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.

Olive Liwimbi (O)

Ministry of Health, Zomba Mental Hospital, Zomba, Malawi.

Michael Udedi (M)

Ministry of Health, NCDs and Mental Health Unit, Lilongwe, Malawi; University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC, USA.

Alick Mazenga (A)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.

Phoebe Nyasulu (P)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.

Elaine Abrams (E)

ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Pediatrics, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA.

Saeed Ahmed (S)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi; Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.

Maria H Kim (MH)

Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi; Baylor International Pediatric AIDS Initiative at Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.

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