Thesis Format
Monograph
Degree
Master of Science
Program
Epidemiology and Biostatistics
Supervisor
Anderson, Kelly K.
Abstract
Adverse childhood experiences (ACEs) are associated with psychotic disorders. However, this association has not been examined at the population level. The objective of this thesis was to use health administrative data to estimate the risk of psychotic disorders during adolescence and early adulthood among people who accessed health care for ACEs. ACEs occurring prior to age 12 years were identified in the health administrative data, and follow-up to identify first-onset psychotic disorders occurred from 12 to 27-31 years of age. The results indicated that ACEs increase the risk of psychotic disorders. Furthermore, the risk increases with increasing number of types of ACEs. The incident rate ratio (IRR) for 4+ ACEs was 4.04 (95% Confidence Interval: 3.26 to 5.01). Our findings add to the existing literature on the association between ACEs and psychotic disorders.
Summary for Lay Audience
Adverse childhood experiences (ACEs) refer to stressful or traumatic events during childhood. In research, they often refer to physical, sexual, and emotional abuse; physical and emotional neglect; and household problems such as divorce, violence between legal guardians, incarceration, substance abuse, or mental illness of a parent. The definition of ACEs can also be expanded to include experiences of bullying, discrimination, and poverty. ACEs can often lead to many negative health consequences later in life, including psychotic disorders, which are a group of mental illnesses that affect the individual’s perception of reality. Most studies examining ACEs and psychotic disorders were done outside of Canada and looked at specific subgroups of people, such as those who accessed early support for psychotic disorders or who participated in research studies. This thesis took a population-based perspective, and attempted to include nearly all people born in Ontario for whom information was available. Our sample included children born between 1992 and 1996 in Ontario, and we used data from the health care system to identify visits to healthcare for ACEs up to 12 years of age. Psychotic disorders were identified between 12 years of age until 27-30 years of age. The results indicated that ACEs increase the risk of psychotic disorders, and the risk increases with a greater number of healthcare encounters for different types of ACEs. The results support the evidence from previous research and inform policy makers of the pervasiveness of ACEs in the Ontario population as well as its adverse effect on psychotic disorders.
Recommended Citation
Salama, Ramez, "Incidence of Psychotic Disorders Among Children with Adverse Childhood Experiences: A Retrospective Birth Cohort Study Using Health Administrative Data" (2024). Electronic Thesis and Dissertation Repository. 10240.
https://ir.lib.uwo.ca/etd/10240
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