The Association of Adverse Childhood Experiences with Long-term Mood and Anxiety Disorders After Childhood Traumatic Brain Injury: A Population-based Case-Control Study.
Dmitry Esterov, Emily Hines, Alyssa A Neumann and 2 others
PMID 37467935WHAT IT FOUND
After childhood TBI, at least one documented adverse childhood experience was associated with later mood or anxiety disorders: 91 of 114 children who developed them versus 41 of 114 matched children who did not.
The study cannot show cause.
Key findings
01After childhood TBI, at least one documented adverse childhood experience was more common in children who later developed a mood or anxiety disorder: 91 of 114 cases versus 41 of 114 matched controls.
02The association between at least one documented adverse childhood experience and later mood or anxiety disorder did not substantially change when the analysis considered injury severity, repeat TBI, learning disability, maternal depression, and other factors.
03The sample was mainly mild or possible TBI: only 3 cases and 1 control had definite TBI.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study could not determine whether adverse childhood experiences happened before or after the TBI, so it cannot establish direction or causality. The sample was mostly children with mild or possible TBI; only 3 cases and 1 control had definite TBI, so findings may not apply to moderate or severe TBI. The injuries occurred between 1976 and 1982, so current treatment for TBI and mood or anxiety disorders may differ. The cohort was from the Upper Midwest of the United States and was less ethnically diverse and higher in socioeconomic status than the overall U.S. population. Adverse childhood experiences were abstracted from medical records, and often lacked timing. The paper defined 115 cases but reported 114 matched pairs, and bipolar disorder was combined with depressive disorders because only 5 cases had bipolar disorder. Cases had higher odds of prior ADHD diagnosis; adjusting for ADHD changed the odds ratio from 5.17 to 4.86.
Declared interests
The authors declared no conflicts of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that adverse childhood experiences cause later mood or anxiety disorders after childhood TBI, or that routine screening will improve outcomes. The study found an association in a case-control sample, could not determine whether adverse childhood experiences happened before or after TBI, and says more research is needed before routine screening can be recommended.