Mediating role of depressive symptoms in the association between adverse childhood experiences and asthma

Abstract

Background: Adverse childhood experiences (ACEs) are associated with asthma, but the role of depressive symptoms (DS) in this is poorly studied.

Objective: The aim of this study was to investigate the mediating effect of DS on ACEs and asthma.

Participants and setting: This study was a retrospective cohort study of participants from the China Longitudinal Study of Health and Retirement from 2011 to 2018. A total of 12,277 participants including 5942 males and 6335 females were involved in the study.

Methods: DS were assessed using the 10-item short form of the Center for Epidemiological Research Depression Scale. Logistic regression adjusted for confounders was used to explore the relationship between ACEs with asthma. Mediating effect analysis was used to assess the role of DS in the relationship between ACEs and asthma.

Results: The results of logistic regression showed that there were an association between ACEs and asthma. Mediating effect analysis revealed that among the 15 ACEs examined, DS had partial mediating effects on the association between asthma and 5 specific ACEs (feeling alone, peer bullied, self-reported health status, health limitation, and death of parents), and fully mediated the relationship between asthma and another 5 ACEs (death of siblings, childhood neighborhood safety, childhood neighborhood quality, physical abuse, and parents' mental health) (all p < .05).

Conclusion: ACEs are significantly associated with an increased risk of asthma, and DS play a mediating role in the relationship between ACEs and asthma.

Keywords: Adverse childhood experiences; Asthma; Depressive symptoms; Mediating effect.