Adverse childhood experiences and chronic pain in adolescent patients with depressive disorder: the mediating role of circadian rhythm disruption

Abstract

Background: There is growing evidence that adolescent patients with depressive disorder often experience somatic pain symptoms, but the evidence is inconclusive, and the underlying mechanisms are less known.

Methods: From October 2023 to October 2024,a cross-sectional study of the participants were recruited 256 participants from the Mental Health Clinic of the General Hospital of Ningxia Medical University. Using Chinese version of Revised Adverse Childhood Experience Questionnaire, Adolescent Biological Rhythm Disorder Evaluation Questionnaire and the Numeric Rating Scale for Pain. Statistical analysis was performed using Pearson correlation and mediation analysis.

Results: A total of 256 participants were enrolled in our study with a mean age of 15.65 ± 2.04 years. The majority of them were women (72.3%). Adverse childhood experiences and circadian rhythm disruption were significantly positively correlated with chronic pain. The mediation analysis showed that the circadian rhythm disruption of adolescent depressive disorder played a partial mediating role in adverse childhood experiences and chronic pain, and the mediating effect accounted for 25.51% of the total effect.

Conclusion: In adolescents with depressive disorder, adverse childhood experiences could positively predict chronic pain, and circadian rhythms disruption had a partial mediating effect on adverse childhood experiences and chronic pain. Future research should expand the sample size and adopt longitudinal designs, and further exploring the mechanism of circadian rhythms disruption in adverse childhood experiences and chronic pain.

Keywords: Adverse childhood experiences; Chronic pain; Circadian rhythm disruption; Depressive disorder; Mediation analysis.

Fig. 1

The path relationship between circadian rhythm disruption in adverse childhood experience and chronic pain