Objective: Adverse childhood experiences are linked to the development of a number of psychiatric illnesses in adulthood. Our study examined the pattern of adverse childhood experiences and their relation to the age of onset of major psychiatric conditions in individuals from families that had ⩾2 first-degree relatives with major psychiatric conditions (multiplex families), identified as part of an ongoing longitudinal study. Methods: Our sample consisted of 509 individuals from 215 families. Of these, 268 were affected, i.e., diagnosed with bipolar disorder ( n = 61), obsessive–compulsive disorder ( n = 58), schizophrenia ( n = 52), substance dependence ( n = 59) or co-occurring diagnoses ( n = 38), while 241 were at-risk first-degree relatives who were either unaffected ( n = 210) or had other depressive or anxiety disorders ( n = 31). All individuals were evaluated using the Adverse Childhood Experiences – International Questionnaire and total adverse childhood experiences exposure and severity scores were calculated. Results: It was seen that affected males, as a group, had the greatest adverse childhood experiences exposure and severity scores in our sample. A Cox mixed effects model fit by gender revealed that a higher total adverse childhood experiences severity score was associated with significantly increased risk for an earlier age of onset of psychiatric diagnoses in males. A similar model that evaluated the interaction of diagnosis revealed an earlier age of onset in obsessive–compulsive disorder and substance dependence, but not in schizophrenia and bipolar disorder. Conclusion: Our study indicates that adverse childhood experiences were associated with an earlier onset of major psychiatric conditions in men and individuals diagnosed with obsessive–compulsive disorder and substance dependence. Ongoing longitudinal assessments in first-degree relatives from these families are expected to identify mechanisms underlying this relationship.

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Background: Mental illnesses often cluster in families, and their impact on affected and unaffected members within families need to be understood from a social perspective. Methods: Data was derived from 202 families with multiple affected individuals, identified under Accelerator program for Discovery in Brain disorders using Stem cells (ADBS) study. Affected individuals (N=259) had a diagnosis of schizophrenia, bipolar disorder, obsessive-compulsive disorder or substance use disorder. For comparison, we used the unaffected siblings from the same families (N=229), and a matched random subset of healthy control (HC) data from the National Mental Health Survey (NMHS) (total N=34,802). We compared educational attainment, functional marital status and occupational status between the groups. Results: The groups were matched across age, gender and place of residence. The highest educational attainment was significantly different between the groups. The affected (9.9 years) and unaffected siblings (10.4 years) had poor educational attainment compared to HC (11.6 years), (F=8.97, p<0.001). Similarly the affected (43%) and unaffected siblings (33%) remained more often single, in contrast to HC (23%), (χ2=40.98.17, p<0.001). However, the unaffected siblings (4%) were less unemployed when compared with HC (9%). When comparing gender specific, females had overall lesser educational attainment, were largely married, and were majority homemakers across the three groups when compared to males. Discussion: Our study findings reveal the socio-demographic characteristics of affected and unaffected siblings from multiplex families in Indian context. Affected and unaffected siblings had lower educational attainment and higher marital dysfunction when compared to HC. Whereas, the unaffected siblings were more likely to be in employment compared to HC. Whether the poor educational attainment and marital functioning in unaffected siblings is a biological marker of shared endophenotype or the effect of social burden of having an affected family member requires further systematic evaluation.

Objective: Adverse Childhood Experiences (ACEs) are linked to the development of a number of psychiatric illnesses in adulthood. Our study examined the pattern of ACEs and their relation to the age of onset (AAO) of major psychiatric conditions in individuals from families that had ≥ 2 first degree relatives with major psychiatric conditions (multiplex families) identified as part of an ongoing longitudinal study. Methods:Our sample consisted of 509 individuals from 215 families. Of these, 268 were affected i.e diagnosed with bipolar disorder (BPAD) (n=61), obsessive-compulsive disorder (OCD) (n=58), schizophrenia (n=52), substance dependence (SUD) (n=59), or co-occurring diagnoses (n=38); while 241 were at-risk first degree relatives (FDRs) who were either unaffected (n=210) or had other depressive or anxiety disorders (n=31). All individuals were evaluated using the Adverse Childhood Experiences -International Questionnaire (ACE-IQ) and ACE binary and frequency scores were calculated.Results: It was seen that affected males, as a group, had the greatest ACE scores in our sample. A cox mixed-effects model fit by gender revealed that higher ACE binary and frequency scores were associated with significantly increased risk for an earlier AAO of psychiatric diagnoses in males. A similar model that evaluated the effect of diagnosis revealed an earlier AAO in OCD and SUD, but not in schizophrenia and BPAD. Conclusions:Our study indicates that ACEs brought forward the onset of major psychiatric conditions in men and in individuals diagnosed with OCD and SUD. Ongoing longitudinal assessments in FDRs from these families are expected to identify mechanisms underlying this relationship.

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