title: Adverse childhood experiences and gender influence treatment seeking behaviors in obsessive-compulsive disorder.
abstract: BACKGROUND
  Exposure to adverse childhood experiences (ACE) increases the risk of adult physical and mental health disorders, including obsessive-compulsive disorder (OCD), and influences adult brain structure and function. ACE could influence the use of psychotropic drugs in adulthood, and treatment seeking behaviors.
  
  
  METHODS
  We assessed the severity of ACE in a sample of 31 healthy controls and 66 patients with OCD who were consecutively referred for hospitalization and were either drug-naïve or drug-treated. In addition, we explored the possible clinical relevance of ACE with two additional analyses: (a) a discriminant function analysis with sex and ACE as factors, and (b) a logistic regression with use of medication as dependent variable and ACE as factor.
  
  
  RESULTS
  Despite comparable age, years at school, age at onset of illness, duration of illness, and severity of illness (Y-BOCS), adult drug-naïve patients reported lower exposure to ACE and later contacts with mental health professionals than drug-treated. This effect was particularly evident in female patients compared to males.
  
  
  CONCLUSIONS
  The interaction of gender with factors linked with the early familial environment biased access to psychiatric care and use of medication, independent of OCD-associated factors such as severity of symptoms or duration of illness. The need for medications of patients could be higher in families where OCD symptomatology is associated with ACE.
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute, San Raffaele, Milan.
authors.forename: Francesco
authors.initials: F
authors.lastname: Benedetti
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute, San Raffaele, Milan. Electronic address: poletti.sara@hsr.it.
authors.forename: Sara
authors.initials: S
authors.lastname: Poletti
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute, San Raffaele, Milan.
authors.forename: Daniele
authors.initials: D
authors.lastname: Radaelli
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute, San Raffaele, Milan.
authors.forename: Elena
authors.initials: E
authors.lastname: Pozzi
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute, San Raffaele, Milan.
authors.forename: Chiara
authors.initials: C
authors.lastname: Giacosa
authors.affiliation: Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute, San Raffaele, Milan.
authors.forename: Enrico
authors.initials: E
authors.lastname: Smeraldi
mesh_terms: D000328:Adult; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors