Abstract Details

Title Adverse Childhood Experiences in Patients with Neurological Disease

Topic General Neurology

Presentation(s) S21 - Neuroepidemiology (4:30 PM-4:42 PM)

Poster/Presentation
Number 006

Objective To describe the prevalence of adverse childhood experiences (ACEs) among neurology patients, and determine the association between high ACEs, healthcare utilization rates and comorbid mental health illness.

Background ACEs have been linked to numerous medical conditions including cardiovascular disease, diabetes, and mental illness. An ACE score >4 has also been linked to increased healthcare utilization. There is limited knowledge about the prevalence of high ACEs or their effect on healthcare utilization in patients with neurologic diseases.

Design/Methods This is an ongoing case-control study of adult patients seen in follow up in an outpatient neurology practice at the Hospital of the University of Pennsylvania. A score >4 was considered a high ACE. Healthcare utilization was measured by number of patient-reported emergency department visits/hospitalizations and chart review of outpatient phone calls. Participants were also asked to fill out depression and anxiety questionnaires (PHQ2 and GAD 2). Patients with cognitive impairment were excluded from the study. By the completion of the study, we aim to analyze 350 responses

Results There are 111 participants currently enrolled. 19.8% have high ACE scores, higher in comparison to US population averages (19.8% vs 12.6%, p=0.01). High ACEs were seen across all neurological conditions, with the greatest percentage seen in Stroke (30.8%), Demyelinating Disease (18.2%), and Epilepsy (14.7%). High ACEs were associated with more than 4 ED visits in one year (OR=6.21, p=0.027). High ACEs were also associated with high scores on the PHQ2 depression questionnaire (OR=10.42, p=0.002). We did not see an association between high ACEs, hospital admissions, telephone encounters, or elevated anxiety scores.

Conclusions Patients with neurological conditions are more likely to have high ACEs in comparison to the general population. Addressing adverse childhood experiences may be a potential mechanism to decrease healthcare utilization and improve the management of complex patients with neurological conditions.

Authors/Disclosures
Adys Mendizabal, MD, MS (UCLA) PRESENTER	Dr. Mendizabal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine Biosciences. Dr. Mendizabal has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Clinical ��ɫ�� Alliance. Dr. Mendizabal has received research support from Huntington's Disease Society of America.
Cody L. Nathan, MD (Northwestern Medical Hospital)	Dr. Nathan has nothing to disclose.
Pouya Khankhanian, MD (Kaiser Dublin)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Nabila Dahodwala, MD, FAAN (Parkinson's disease and Movement Disorders Center)	Dr. Dahodwala has received personal compensation in the range of $0-$499 for serving as a Consultant for Genetech. Dr. Dahodwala has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mediflix. Dr. Dahodwala has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia. Dr. Dahodwala has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Post and Schell. Dr. Dahodwala has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for O'Brien & Ryan, LLP. The institution of Dr. Dahodwala has received research support from AbbVie. The institution of Dr. Dahodwala has received research support from Medtronic.

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