Adverse childhood experience among patients with severe mood disorders in Gedeo Zone Public Hospitals, Southern Ethiopia:A multisite cross-sectional study

OBJECTIVE: To assess prevalence and associated factors of adverse childhood experiences (ACEs) among patients with severe mood disorders (SMDs). DESIGN: An institution-based cross-sectional study. SETTING: Gedeo Zone Public Hospitals, Southern Ethiopia. PARTICIPANTS: 374 patients with SMDs were recruited using a systematic sampling technique. PRIMARY AND SECONDARY OUTCOME MEASURES: The data were collected using an interview-administered questionnaire and medical chart review. The outcome variable was assessed using the ACEs questionnaire. Data were coded and entered into Epi Data 3.1 and analysed using SPSS V.26. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with ACEs. The presence of an association was examined using an adjusted OR (AOR) with a 95% CI. Variables with P-values less than 0.05 were considered a statistically significant association. RESULTS: The overall prevalence of ACEs among patients with SMDs was 51.6% (95% CI 49.2 to 53.9), and the prevalence of ACEs among patients with severe bipolar disorders and depressive disorders was 14.7% with (95% CI 46.8 to 52.4) and 36.9% with (95% CI 46.7 to 55.8), respectively. Having low socioeconomic status (SES) (AOR=2.04 (95% CI 1.40 to 3.45), poor social support (AOR=2.43 (95% CI 1.74 to 4.17)), low resilient coping strategies (AOR=1.48 (95% CI 1.21 to 2.83)) and severity of depressive symptoms (AOR=3.82 (95% CI 2.89 to 6.00)) were significantly associated with ACEs. CONCLUSION: This study reveals a high prevalence of ACEs among patients with SMDs, with more than half of the participants reporting at least one ACE. Low SES, low resilient coping strategies and poor social support were factors significantly associated with ACEs, and severe depressive symptoms were significantly associated with ACEs. Therefore, these findings underscore the importance of early screening and appropriate intervention for SMDs and ACEs, and providing more holistic mental healthcare for SMDs and ACEs, improving access to education and economic support, strengthening social support networks, enhancing resilience-building programmes and integrating routine ACEs assessments into mental health evaluations could potentially contribute to improved clinical outcomes and support long-term recovery. TRIAL REGISTRATION: Not applicable.