- Abigail Grant, MS, Doctoral Intern, Saint Louis University School of Medicine, Marietta, GA
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.
- Describe the association between ACEs, depressive symptoms, and medication intolerance or allergy
- Recognize implications for multidisciplinary treatment teams
- Apply knowledge of this association when treating patients in primary care