Adverse childhood experiences (ACEs) are well-known risk factors for schizophrenia and bipolar disorder.

The aim was to study the associations between specific ACEs and psychological functioning in women with schizophrenia or bipolar disorder.

Among 29 367 women (mean age 44 years) from the Icelandic Stress-And-Gene-Analysis (SAGA) study, 534 (1.8%, mean age 40) reported having been diagnosed with schizophrenia or bipolar disorder, which were combined to ‘severe mental disorders’. Participants reported on 13 types of ACEs, childhood deprivation and psychological functioning (defined as coping ability and current symptoms of depression, anxiety and sleep disturbances). Adjusted Poisson regression calculated prevalence ratios (PRs) between ACEs and severe mental disorders. Linear regression assessed the association between ACEs and psychological functioning among women with a severe mental disorder.

Women with a severe mental disorder reported more ACEs (mean 4.57, s.d. = 2.82) than women without (mean 2.51, s.d. = 2.34) in a dose-dependent manner (fully-adjusted PR = 1.23 per ACE, 95% CI 1.20–1.27). After mutual adjustment for other ACEs, emotional abuse, sexual abuse, mental illness of a household member, emotional neglect, bullying and collective violence were associated with severe mental disorders. Among women with severe mental disorders, a higher number of ACEs was associated with increased symptom burden of depression (β = 2.79, 95% CI = 1.19–4.38) and anxiety (β = 2.04, 95% CI = 0.99–3.09) including poorer sleep quality (β = 0.83, 95% CI = 0.07–1.59). Findings were similar for schizophrenia and bipolar disorder separately.

Women with schizophrenia or bipolar disorder show a strong history of ACEs, which may interfere with their psychological functioning and, therefore, need to be addressed as part of their treatment, for example, with trauma-focused psychotherapy.

不良童年经历（ACE）是众所周知的精神分裂症和双相情感障碍的危险因素。

目的是研究特定 ACE 与患有精神分裂症或双相情感障碍的女性心理功能之间的关联。

冰岛压力与基因分析 (SAGA) 研究的 29,367 名女性（平均年龄 44 岁）中，有 534 名（1.8%，平均年龄 40 岁）报告被诊断患有精神分裂症或双相情感障碍，这些疾病合并为“严重”精神错乱'。参与者报告了 13 种 ACE、童年剥夺和心理功能（定义为应对能力以及当前的抑郁、焦虑和睡眠障碍症状）。调整后的泊松回归计算了 ACE 与严重精神障碍之间的患病率 (PR)。线性回归评估了患有严重精神障碍的女性中 ACE 与心理功能之间的关联。

患有严重精神障碍的女性报告的 ACE（平均 4.57，sd = 2.82）多于没有严重精神障碍的女性（平均 2.51，sd = 2.34），且呈剂量依赖性（完全调整 PR = 1.23/ACE，95% CI 1.20–1.27） ）。对其他ACE进行相互调整后，情感虐待、性虐待、家庭成员精神疾病、情感忽视、欺凌和集体暴力与严重精神障碍相关。在患有严重精神障碍的女性中，较高的 ACE 数量与抑郁症（β = 2.79，95% CI = 1.19–4.38）和焦虑症（β = 2.04，95% CI = 0.99–3.09）症状负担增加相关，包括较差的精神障碍。睡眠质量（β = 0.83，95% CI = 0.07–1.59）。精神分裂症和双相情感障碍的研究结果相似。

患有精神分裂症或双相情感障碍的女性有很强的 ACE 病史，这可能会干扰她们的心理功能，因此需要将其作为治疗的一部分来解决，例如以创伤为重点的心理治疗。