RESEARCH - Cumulative childhood stress and autoimmune diseases in adults

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Psychosom Med. 2009 Feb;71(2):243-50. Epub 2009 Feb 2.

Cumulative childhood stress and autoimmune diseases in adults.

Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB.

Centers for Disease Control and Prevention, National Center for

Chronic Disease Prevention and Health Promotion, Division of Adult and

Community Health, 4770 Buford Highway, N.E., MS K-50, Atlanta, GA

30341-3717, USA.

OBJECTIVE: To examine whether childhood traumatic stress increased the

risk of developing autoimmune diseases as an adult.

METHODS: Retrospective cohort study of 15,357 adult health maintenance

organization members enrolled in the Adverse Childhood Experiences

(ACEs) Study from 1995 to 1997 in San Diego, California, and eligible

for follow-up through 2005. ACEs included childhood physical,

emotional, or sexual abuse; witnessing domestic violence; growing up

with household substance abuse, mental illness, parental divorce,

and/or an incarcerated household member. The total number of ACEs (ACE

Score range = 0-8) was used as a measure of cumulative childhood

stress. The outcome was hospitalizations for any of 21 selected

autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1)

(e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia

gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2

(e.g., autoimmune hemolytic anemia).

RESULTS: Sixty-four percent reported at least one ACE. The event rate

(per 10,000 person-years) for a first hospitalization with any

autoimmune disease was 31.4 in women and 34.4 in men. First

hospitalizations for any autoimmune disease increased with increasing

number of ACEs (p < .05). Compared with persons with no ACEs, persons

with >or=2 ACEs were at a 70% increased risk for hospitalizations with

Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic

diseases (p < .05).

CONCLUSIONS: Childhood traumatic stress increased the likelihood of

hospitalization with a diagnosed autoimmune disease decades into

adulthood. These findings are consistent with recent biological

studies on the impact of early life stress on subsequent inflammatory

responses.

PMID: 19188532

http://www.ncbi.nlm.nih.gov/pubmed/19188532

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