The effect of adverse childhood experiences on depression, psychological distress and suicidal thought in Vietnamese adolescents: Findings from multiple cross-sectional studies.

Exposing to adverse childhood experiences (ACEs) has been identified as one of the major contributing factors to poor mental health and suicide in adolescents. However, little is known about this relationship in Vietnamese adolescents. This study aimed to evaluate the effect of ACEs on depression, psychological distress and suicidal thought among Vietnamese adolescents across different areas in Vietnam. Cross-sectional surveys were conducted among 4957 secondary school and high school students aged 13-20 in urban area, rural area, border area and mountainous area. The students were asked to complete a self-report questionnaire which included the Center for Epidemiological studies - Depression, the Kessler-10 and ACE questionnaire from the WHO Adverse Childhood Experiences Study. Suicidal thought was evaluated by a single question from the U.S. Youth Risk Behavior Survey. Among 4720 students included in the analysis, 54.4% were female. The prevalence of depression, psychological distress and suicidal thought was 22.9%, 30.6% and 10.9% respectively. About 86% of participants experienced at least one type of ACEs and nearly 56% reported multiple types of ACEs. Students with four or more types of ACEs had 6.98 (95% CI 5.09 -9.56), 4.72 (95 % CI 3.58-6.23) and 6.43 (95 % CI 4.45-9.30) times higher in odds of having depression, psychological distress and suicidal thought respectively. In conclusion, ACEs are common in Vietnamese adolescents and are strongly associated with depression, psychological distress and suicidal thought. Our finding indicates urgent needs for interventions targeting both ACEs and depression, psychological distress in Vietnamese adolescents.