A01 – Depressive Symptoms as a Mediator in the Association between Adverse Childhood Experiences and Perceived Medication Intolerance and Poly-Allergy

Summary

The association between adverse childhood experiences (ACEs) and mental health conditions (i.e. depression, anxiety, PTSD) and physical health conditions (i.e. heart disease, cancer, autoimmune diseases) has been well-established. However, the association between ACEs and medication intolerance or poly-allergy is less understood. Thus, the present study examined whether depressive symptoms serve as a mediator in the association between ACEs and perceived multiple drug allergies in a primary care population. Three hundred forty-nine participants were recruited from 11 primary care clinics and hospitals located in a metropolitan area of Missouri. Structural equation modeling was used to measure ACEs, symptoms of depression and anxiety, and medication intolerance. The following variables were collected using an online survey: ACEs, patient health, patient health behavior, demographics, and drug allergies. Results indicate that participants had on average 1 allergy each (mean = 0.93) and 20% of participants reported having more than one allergy. Additionally, 46% of participants reported experiencing at least one ACE. Results indicated a dose-dependent association between ACEs and allergies to medication, establishing a pathway between ACEs, depression, and multiple drug allergy. The proposed explanation for this sequalae examines a combined effect of ACEs and depression on an individual’s inflammatory response, altering their perception of allergy. By increasing knowledge of such pathway, providers in primary care settings can be better-informed when prescribing medication and maintaining adherence from patients.