[The association between adverse childhood experiences and comorbid anxiety/depression in irritable bowel syndrome: A...

Objective: Leveraging data from the UK Biobank, this study investigated the association between adverse childhood experiences (ACEs) and anxiety/depression comorbidity among patients with irritable bowel syndrome (IBS). Whether any potential association was specific to the IBS population was also evaluated. Methods: This was a retrospective case-control study. The data extraction cutoff date was October 6, 2023. A total of 11 027 patients with diagnosed IBS were included as the case group for primary analysis, and 144 536 non-IBS participants from the same period were included as the control group for specificity verification. Multivariate logistic regression models were used to assess the association between ACEs and anxiety/depression, adjusting for potential confounding factors, including age, sex, adverse life events in adulthood, smoking, alcohol consumption, body mass index (BMI), socioeconomic status, and overall health. Subgroup analyses were further conducted stratified by age and sex. Finally, interaction analyses were performed to test whether the impacts of ACEs differed between the IBS and control groups. Results: The prevalence of comorbid anxiety or depression among the 11 027 patients with IBS was 32.09%. Multivariate analysis revealed that compared with patients with no history of ACEs, those reporting two or more ACEs had a 97% increased risk of comorbidity (OR=1.97, 95%CI 1.73-2.24). Each one-point increase in the total ACE score was associated with a 22% increased risk of comorbidity (OR=1.22, 95%CI 1.15-1.29). Among specific ACE types, emotional neglect (OR=1.90, 95%CI 1.66-2.19) and emotional abuse (OR=1.71, 95%CI 1.52-1.92) showed the strongest associations with comorbid anxiety/depression. Subgroup analyses indicated that these associations remained statistically significant across sexes, as well as in participants aged both 60 years and older and younger than 60 years. Interaction analyses revealed that the risk for anxiety/depression risk associated with ACEs did not differ significantly between the IBS and control groups; each one-point increase in the total ACE score was associated with a similar increase in risk in the IBS group (OR=1.22, 95%CI 1.15-1.29) and the control group (OR=1.24, 95%CI 1.21-1.27), with no statistically significant difference in effect size. Conclusion: ACEs, particularly emotional trauma, are robustly associated with anxiety and depression comorbidity among patients with IBS. Although the association appears consistent between IBS patients and the general population, IBS patients with a history of emotional trauma exhibit a higher prevalence of psychological comorbidity. Thus, they represent a high-risk group that warrants clinical prioritization.