title: Adverse childhood experiences, smoking and mental illness in adulthood: a preliminary study.
abstract: BACKGROUND
  Adverse childhood experiences (ACE) are associated with mental illness and smoking in adulthood, but ACE has not been studied as a determinant of this comorbidity. This study was designed to examine effects of ACE on the expression of smoking behavior and mental illness in adulthood.
  
  
  METHODS
  We examined the relationship between ACE, smoking status, and the expression of serious mental illness in adults (n = 101). Subjects were evaluated with a semi-structured interview that included psychiatric status, smoking status, substance abuse and presence and severity of ACE. Subjects were grouped into four categories based on psychiatric and smoking status: psychiatric smokers (PS), psychiatric nonsmokers (PNS), control smokers (CS) and control nonsmokers (CNS).
  
  
  RESULTS
  ACE was associated with serious mental illness or smoking behaviors in adulthood, and to a lesser extent with co-morbid mental illness and smoking. Cumulative number of ACE was highest in the order of PS > PNS > CS > CNS.
  
  
  CONCLUSIONS
  These preliminary results suggest an association between the presence of ACE and the expression of severe mental illness in adulthood, and possibly to comorbid smoking and mental illness. Longitudinal research using larger samples is needed to determine the causal relationship between ACE and co-morbid smoking and mental illness.
authors.affiliation: Program for Research in Smokers with Mental Illness (PRISM), Connecticut Mental Health Center, Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06519, USA. kristi.sacco@yale.edu
authors.forename: Kristi A
authors.initials: KA
authors.lastname: Sacco
authors.forename: Cory A
authors.initials: CA
authors.lastname: Head
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Vessicchio
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Easton
authors.forename: Holly G
authors.initials: HG
authors.lastname: Prigerson
authors.forename: Tony P
authors.initials: TP
authors.lastname: George
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D013223:Statistics as Topic; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology