Adverse Childhood Events are Associated with Poor Mental Health in Young, Newly Married Women in Nepal

Adverse childhood events are associated with short- and long-term physical and mental health outcomes, as well as risk of future continued exposure to violence. There is limited research on adverse childhood events in lower resource settings and its impact on mental health among women. Using data from 200 newly married women living in rural Nepal, we explored the impact of adverse childhood events on depressive symptoms and intimate partner violence (IPV) in early adulthood. Most study participants reported at least one adverse childhood experience (ACE) (58.5%), one-quarter depressive symptoms (24.5%), and one-quarter (24.5%) reported any IPV. Each ACE reported was associated with a mean 1.92-point increase in depressive symptom score (95% confidence interval [CI] [1.11, 2.73]) and a mean 0.23-point (95% CI [0.20, 0.36]) increase in severity of IPV. IPV was identified as an independent contributor to but not a significant mediator of depressive symptoms. These findings suggest that ACEs are an important influencer of young adult poor mental health, particularly among women, and inform the unique pathways through which distal and proximate factors such as these influence mental health status. Policies and programs are needed not only to prevent and mitigate the impact of ACEs in the natal home, but also to target the marital home and the transition to marriage as key opportunities to build safe spaces and support for young married women in Nepal and similar contexts.