University of Michigan, School of Nursing, Ann Arbor, MI, United States of America.
Department of Psychiatry, St. Joseph Mercy Health System, Ann Arbor, MI, United States of America.
J Psychosom Res. 2022 Sep;160:110981. doi: 10.1016/j.jpsychores.2022.110981. Epub 2022 Jun 25.
Adverse Childhood Experiences (ACEs), such as physical, emotional, and sexual abuse trigger inflammatory changes and have been associated with many causes of morbidity and mortality, including autoimmune diseases. Although Multiple Sclerosis (MS) is a debilitating neurological autoimmune disease, literature linking ACEs and MS is understudied. The aim of this review was to examine the 1) state of the literature, and 2) relationships between childhood adversity and the prevalence and physical clinical features of MS (e.g., age at onset, relapses, pain, fatigue, disability).
A comprehensive search was preformed through five databases and by hand using the ancestry and descendancy approach for connections to papers published through January 20th, 2022. Studies were screened by independent reviewers using Rayyan.ai, and critically appraised for both quality and reporting transparency.
Twelve studies examined relationships between any ACE(s) and the prevalence or physical clinical features of MS. There was considerable variance in the measurement of stressors, confounders, and categorization of MS; however most studies (n = 10) demonstrated an association between ACEs and MS (alone or grouped with other similar diagnoses), or physical clinical features.
Although there are few studies in this area, it is of quickly growing interest. These results should be cautiously interpreted, yet highlight the need for continued work to disentangle and discern true associations.
不良童年经历(ACEs),如身体、情感和性虐待会引发炎症变化,并与许多疾病的发病率和死亡率有关,包括自身免疫性疾病。尽管多发性硬化症(MS)是一种使人衰弱的神经自身免疫性疾病,但将 ACEs 与 MS 联系起来的文献研究还很不足。本综述的目的是检查 1)文献现状,2)儿童期逆境与 MS 的患病率和身体临床特征(例如发病年龄、复发、疼痛、疲劳、残疾)之间的关系。
通过五个数据库进行全面检索,并通过祖先和后裔的方法手动检索,以获取截止到 2022 年 1 月 20 日发表的论文。研究由独立评审员使用 Rayyan.ai 进行筛选,并对质量和报告透明度进行了严格评估。
有 12 项研究检查了任何 ACE(s)与 MS 的患病率或身体临床特征之间的关系。在压力源、混杂因素和 MS 分类的测量方面存在很大差异;然而,大多数研究(n=10)表明 ACEs 与 MS(单独或与其他类似诊断一起)或身体临床特征之间存在关联。
尽管该领域的研究很少,但它的关注度正在迅速增加。这些结果的解释应谨慎,但强调需要继续努力以厘清和辨别真正的关联。