Early life adversity and the comorbidity of psychopathology and cardiometabolic disorders: insights from the UK Biobank.

Introduction: Early life adversity is associated with both psychopathology and cardiometabolic diseases, suggesting shared developmental risk factors and biological mechanisms. We aimed to investigate the associations between early life adversity and psychopathology, cardiometabolic diseases and their comorbidity. Methods: Cross-sectional study with participants from the UK Biobank cohort, composed of 502 543 individuals ranging from 37 to 73 years of age. Samples were collected between 2006 and 2010. Participants were excluded if fitting any of the exclusion criteria-dropouts, inconsistencies in reported versus genotyped sex, inconsistencies in assigned family structure, missing covariates data. We employed generalised estimated equations to evaluate the associations between self-reported adversity and outcomes. Adversity was measured through three scores: prenatal (n=234 817), postnatal (n=151 297) and cumulative (n=82 758). Outcomes were psychopathologies (mental/behaviour disorder due to substance use, mood disorders, schizophrenia, neurotic/stress-related) and cardiometabolic diseases (type 2 diabetes, ischaemic heart disease, atherosclerosis, cerebral infarction, cerebral atherosclerosis). Results: The cumulative combined adversity score predicted comorbidity (OR = 1.38, 95% CI 1.31 to 1.45, p<0.01), as well as all outcomes except cerebral infarction. Similar results were observed analysing prenatal (OR=1.27, 95% CI 1.23 to 1.31, p<0.01) and postnatal (OR=1.43, 95% CI 1.36 to 1.50, p<0.01) adversity scores. Conclusion: Early life adversity may be associated with a common cascade of events linked to both psychopathologic and cardiometabolic diseases, which has profound implications for early prevention, diagnosis and treatment.