Investigation of the relationship of adverse childhood experiences and chronic diseases in adult period

Aim: The aim of this study was to determine the relationship between the negative childhood experiences and chronic diseases in adulthood of patients aged 18-65 years who applied to the Akdeniz University Faculty of Medicine, Department of Family Medicine Outpatient Clinic, agreed to participate in the study and gave consent. Methods: Our research, which was designed as descriptive and cross-sectional, was conducted by face-to-face interviews through a questionnaire. The ACE-IQ questionnaire, which evaluates the social violence, socio-demographic characteristics, marriage and parenting processes, parent/caregiver relationships, family environments, domestic violence situations, frequency of neglect and abuse, they experienced, and the chronic diseases questionnaire, which was conducted to learn about the chronic diseases of the participants, if any, were administered to the individuals participating in the study. In order to examine the relationship between ACEs and chronic diseases, independent sample t-test analysis was applied in paired groups and analysis of variance (ANOVA) was applied in groups of three or more. Sidak paired comparison test was used to determine the groups that were determined as different as a result of variance analysis. In the study, t-test analysis, analysis of variance, and chi-square statistics were used to examine patient characteristics according to patient and control groups. In the study, Chi-square statistics were used to examine ACE trauma patient groups and disease states. Descriptive statistics related to the analysis of the data are presented with frequency, percentage, mean and standard deviation values. P values less than 0.05 were considered statistically significant in the study. Analyzes were made with SPSS 25.0 package program. Findings: The total number of participants in the study is 300 people and 52.3% of the participants are men and 47.7% are women. Half of the total participants have at least one chronic disease, 50% of the participants do not have any chronic diseases. The most common disease in participants with chronic disease is DM with a rate of 26.9%. The most common disease group in participants with chronic diseases is endocrine diseases with 42.5%. According to both ACE groups and ACE scoring, those with chronic disease had higher marital trauma, parent/caregiver relationship trauma, abuse trauma, and ACE total score compared to those without chronic disease (p<0.05). The level of violence trauma was found to be higher in those without chronic disease (p<0.05). The level of marital trauma was found to be higher in those with cardiovascular disease, endocrine disease, rheumatic disease, respiratory disease, neurological disease and psychiatric disease (p<0.05). The level of trauma in the family environment was found to be higher in those with cardiovascular disease, endocrine disease, cancer, respiratory disease and psychiatric disease (p<0.05). The level of trauma in parent/caregiver relationships was higher in patients with cardiovascular disease, endocrine disease and psychiatric disease (p<0.05). Abuse trauma level was found to be higher in patients with cardiovascular disease, endocrine disease, cancer, gastrointestinal disease and psychiatric disease (p<0.05). Violance trauma level was found to be higher in patients with cardiovascular disease and gastrointestinal disease (p<0.05). ACE total trauma level was higher in patients with cardiovascular disease, endocrine disease, cancer, respiratory disease, gastrointestinal disease, and psychiatric disease. Conclusions: ACEs plays a direct role in the formation of chronic diseases. The highest level of association with ACEs was seen in cardiovascular diseases, endocrine diseases and psychiatric diseases. Considering the total ACE levels, it has been determined that ACEs play a role in the formation of cardiovascular diseases, endocrine diseases, cancers, respiratory diseases, gastrointestinal diseases and psychiatric diseases. With the contribution of studies on all these negative experiences in childhood, causes such as risky health behaviors, toxic stress and psychological traumas that pave the way for chronic diseases can be prevented. More specific studies on trauma and disease will be important to shed light on the links between ACEs and chronic diseases. It should not be forgotten that understanding the causes of chronic diseases and eliminating them is as important as treating these diseases. Keywords: Adverse childhood experiences, chronic diseases, ACE-IQ questionnaire, questionnaire for chronic diseases