Can adverse childhood experiences worsen lupus symptoms?

Adverse childhood experiences (ACEs) encompass traumas such as abuse, neglect, and household challenges. In an Arthritis Care & Research study of adults with lupus, higher ACE levels, as well as the presence of ACEs from each of these three domains, were associated with worse patient-reported accounts of disease activity, organ damage, depression, physical function, and overall health status.

In the study of 269 patients, more than 60 percent identified at least one ACE, and more than 15 percent indicated at least four ACEs.

“More than half of participants with lupus reported ACE exposure, many of whom experienced substantial trauma in childhood. There is a clear difference in patient-reported outcomes with cumulative ACE exposure in these individuals,” said lead author Dr. Kimberly DeQuattro, of the University of California, San Francisco. “This work in lupus supports more broadly the body of studies on adversity and trauma in childhood that have found a link between ACEs and health. It is a call to action to focus efforts on ACE prevention in childhood as well as clinical and mental health interventions that foster resilience in adulthood.”

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