Adverse childhood experiences and psychotropic medication prescription among cancer patients

Abstract

Background

This study aimed at identifying and characterizing adverse childhood experiences (ACEs) in a sample of cancer patients and subsequently evaluating the relationship between ACEs and prescription of psychotropic medication among them. Individuals with ACEs have a higher risk of mental health conditions and are more likely to be prescribed psychotropic medications.

Methods

A sample of 178 adult patients receiving Supportive Oncology & Survivorship (SOS) services at Huntsman Cancer Hospital in Utah was obtained. ACEs and Brief Resilient Coping Scale (BRCS) questionnaires were administered confidentially. A multivariable mixed effect model, adjusting for sex, age, and insurance type while controlling for zip-codes clustering were employed.

Results

Compared to the prevalence of ACEs in the general population, from the CDC-Kaiser Permanente ACEs Study, we found no significant difference in the prevalence of people who had experienced an adverse childhood event (ACEs score > = 1) between our study of cancer patients and the CDC-Kaiser study (67.4% vs. 63.6%, p = 0.29372), but found a significant difference in the prevalence of people who had experienced severe adverse childhood experiences (ACES score > =4) (25.3% vs. 12.1%, p < 0.00001). Furthermore, this study reveals a significant association between an increase of one unit in the total ACEs score and the odds of psychotropic medication prescription in the past 12 months (OR: 1.233; 95% CI: 1.025, 1.483). Those with a total ACEs score of three or more were found to have 280% higher odds of being prescribed psychotropic medication compared to those with ACEs ≤ 2 (OR: 3.822; 95% CI: 1.404,10.407).

Conclusion

A significant proportion of cancer patients have a history of ACEs, and thus trauma-informed care approach is essential during their treatment.

Keywords:

• Adverse childhood experiences
• cancer
• psychotropic medication

Acknowledgments

We would like to acknowledge Ashley Hafen and Nasim Parsinejad for their help in the process of data collection.

Authors contributions

R.M., P.T., and F.Q. conceptualized and designed the study. S.E.C. worked on the first draft of the manuscript. S.E.C., and F.Q. worked on the data management and statistical analysis. R.M., P.T., and F.Q. edited and reviewed the manuscript.

Disclosure statement

The authors declare no conflict of interest.

Data availability statement

The data will be available upon reasonable request to the principal investigator (Rachel Montague: [email protected]).

Additional information

Funding

This work was funded by the interdisciplinary research seed-grant program of the Supportive Oncology and Survivorship (SOS) Center at the Huntsman Cancer Institute at the University of Utah.