Adverse childhood experiences, traumatic events, and mental health among adults at two outpatient psychiatric facilities in Johannesburg, South Africa: a cross-sectional analysis

BMC Psychiatry

Research

Alexander C. Tsai¹  Aneesa Moolla²  Zoleka Luvuno²  Lesley Chiwaye²  Andrew W. Kim³  Michael Galvin⁴  William Byansi⁵  Radhika Sundararajan⁶ 

[1] Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA;Harvard Medical School, Boston, MA, USA;Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA;Faculty of Health Sciences, Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa;Faculty of Health Sciences, Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa;Department of Anthropology, University of California, Berkeley, United States;Harvard T.H. Chan School of Public Health, Boston, MA, USA;Boston Medical Center, Department of Psychiatry, Boston, MA, USA;Faculty of Health Sciences, Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa;School of Social Work, Boston College, 140 Commonwealth Avenue, 02467, Chestnut Hill, MA, USA;Weill Cornell Center for Global Health, New York City, New York, United States;Department of Emergency Medicine, Weill Cornell Medicine, New York City, New York, United States;

关键词: Adverse childhood experiences;    Anxiety;    Depression;    Interpersonal violence;    Mental illness;    Stress;    Sub-saharan Africa;    Post-traumatic stress;    Psychiatric disorders;   

DOI  :  10.1186/s12888-023-05085-0

 received in 2023-01-04, accepted in 2023-08-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAdverse childhood experiences and adult trauma, including sexual abuse, physical abuse, neglect, and interpersonal violence, are highly prevalent in low-resource settings and associated with adverse psychological outcomes. However, there is limited focus on the impact of ACEs and trauma on mental health in sub-Saharan Africa. Therefore, this study examines the impact of traumatic events and ACEs on depression, anxiety, and stress scores among outpatients receiving psychiatric care at two public mental health treatment facilities in Johannesburg, South Africa.MethodsA sample of 309 participants were recruited between January and June 2022 at Helen Joseph Hospital and Alexandra 18th Avenue Clinic. Participants completed screening measures for mental health outcomes, including the 9-item Patient Health Questionnaire (PHQ-9), the 7-item General Anxiety Disorder scale (GAD-7) and the 10-item Perceived Stress Scale. We fitted modified Poisson and linear regression models to estimate the impact of ACEs and adult experiences of trauma on depression, anxiety, and stress scale scores.Results47.57% (n = 147) of participants screened positive for anxiety, 44.66% (n = 138) for depression, and 17% (n = 54) for severe stress. More females screened positive for anxiety (65.31%), depression (65.94%), and stress (77.78%). Each ACE was associated with a 12% increased risk of depression, a 10% increased risk of anxiety, and a 17% increased risk of stress. In separately estimated models, each additional traumatic event during adulthood was associated with a 16% increased risk for depression, an 8% increased risk of anxiety, and a 26% increased risk of stress. Across all models, being male and self-reported physical health were consistently associated with a reduced risk for depression, anxiety, and stress.ConclusionsACEs and experiences of traumatic events as adults were associated with significantly increased risks of anxiety, depression, and severe stress. Given high exposure to ACEs and trauma and the associated impact on the mental health of individuals, families, and communities, there is a need to strengthen and scale innovative combination interventions that address multiple stressors impacting people in low-resource settings.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023