Frequency and Association between Adverse Childhood Experiences and Psychiatric Outcomes Among Treatment-seeking Patients with Severe Obesity: a Retrospective Observational Study

Abstract

Adverse childhood experiences (ACEs) are well-established risk factors for obesity and psychiatric disorders in adulthood. Despite growing evidence, the association of specific ACE categories with the mental health of patients with severe obesity remains poorly understood. This study aimed to evaluate the frequency of ACEs and the association of ACEs with mental conditions among patients who underwent metabolic bariatric surgery. A total of 141 were recruited from a specialized bariatric center. ACEs were assessed using the Childhood Experiences section of the Composite International Diagnostic Interview 3.0. Psychiatric disorders (current and lifetime) were evaluated using the Structured Clinical Interview for DSM-5. The sample (83.0% women; mean age 52 years; mean BMI 34.2 kg/m²) showed that 91.5% of patients reported at least one ACE, with maltreatment being the most frequent (81.6%). Among the ACE categories, family maladjustment was associated with the highest number of psychiatric disorders, both in current and lifetime assessments. Specifically, it was significantly associated with bipolar disorder (current: OR = 2.9; lifetime: OR = 3.5), any substance use disorder (current: OR = 4.3; lifetime: OR = 5.3), and any anxiety disorder (current: OR = 2.9; lifetime: OR = 2.3). The number of ACEs was associated with current psychiatric disorders (p = 0.04), where each additional ACE increased the odds of current psychiatric disorders by 7% (OR = 1.1, 95% CI: 1.0–1.1). Patients with severe obesity presented a high frequency of ACEs, which was associated with a later risk of developing psychiatric disorders. 91.5% of patients who underwent metabolic bariatric surgery reported at least one ACE. Family maladjustment is associated with bipolar, anxiety and substance use disorders. Each additional childhood trauma was associated with 7% higher odds of current psychiatric disorders. 91.5% of patients who underwent metabolic bariatric surgery reported at least one ACE. Family maladjustment is associated with bipolar, anxiety and substance use disorders. Each additional childhood trauma was associated with 7% higher odds of current psychiatric disorders.