Adverse childhood experiences and care-seeking for depression: evidence from a population-based cohort

BACKGROUND: Major depression is a leading cause of global disability, yet many affected individuals do not seek professional care. Adverse childhood experiences (ACEs) increase the risk and severity of depression, but their influence on care-seeking behavior remains unclear. This study examined whether ACEs are associated with seeking care for depression while accounting for sociodemographic and clinical factors. METHODS: Data stemmed from CoLaus|PsyCoLaus, a longitudinal population-based cohort from Lausanne, Switzerland. Participants aged 45-85 years with a major depressive episode during the follow up were included (N = 759). Logistic regression models assessed the associations between ACEs and consultation for depression of (1) any healthcare professional, and (2) a psychiatrist or psychologist, adjusting for sociodemographic, comorbidity, and depression characteristics. RESULTS: Overall, 63.2% of participants sought any healthcare and 37.5% consulted a mental health professional. Associations between ACEs and consultation of any healthcare professional were no longer significant after adjustment for depression characteristics and comorbidities. A higher number of ACEs remained associated with greater odds of consulting a mental health professional (adjusted OR = 1.21, 95%: 1.03-1.42). Among specific ACEs, childhood caregiving for a parent with mental illness or disability was the only exposure independently associated with mental health care-seeking (adjusted OR = 1.52, 95% CI:1.03-2.24). CONCLUSIONS: ACEs were associated with mental health care-seeking for depression, although most associations were attenuated after accounting for indicators of clinical burden.