# Adverse Childhood Experiences and Psychological Health in Patients with Myasthenia Gravis: A Study Incorporating an Online Positive Mental Health Learning Program

## TL;DR

This study found that many patients with myasthenia gravis experienced adverse childhood events, which linked to higher depression, and an online mental health program improved emotional well-being.

## Contribution

The study introduces a novel online mental health learning program and explores its impact on psychological outcomes in MG patients.

## Key findings

- 42.9% of participants reported at least one adverse childhood experience, with emotional abuse being most common.
- Higher ACE exposure was associated with more severe depressive symptoms in MG patients.
- The online program improved emotional stability, but not other psychological or disease-related outcomes.

## Abstract

Background/Objectives: This study examined the prevalence of adverse childhood experiences (ACEs) among patients with myasthenia gravis (MG) and explored associations between ACE exposure and psychological outcomes. In addition, this study conducted a preliminary evaluation of an online “Positive Mental Health BMI Learning Program” and its association with changes in psychological well-being. Methods: A total of 77 patients with MG were included, with data collected between January 2024 and January 2025. Sociodemographic characteristics, ACE exposure, and psychological and disease-related indicators were assessed, including the Myasthenia Gravis Activities of Daily Living Scale (MG-ADL), the Myasthenia Gravis Quality of Life 15-item scale (MG-QOL15), the indicator of mental health BMI on well-being (mBMI), and the Patient Health Questionnaire-9 (PHQ-9). Using a single-group pre–post design, this exploratory pilot study examined associations between ACEs and psychological outcomes, along with pre–post changes among participants who completed the online program. Results: Among the 32 participants who completed the online program, mBMI scores showed an increase, primarily reflecting improvements in emotional stability (21.41 ± 4.70 to 23.03 ± 4.49, p < 0.01); however, in the absence of a control group, these changes cannot be attributed solely to the intervention. In contrast, no significant pre–post changes were observed in PHQ-9, MG-ADL, and MG-QOL15. Across the full sample, higher ACE exposure was associated with greater depressive symptom severity, as measured by the PHQ-9 (p < 0.05). Overall, 42.9% of participants reported at least one ACE, with emotional abuse being the most frequently endorsed, followed by parental separation or divorce and emotional neglect. Conclusions: ACE exposure was common among patients with MG and was associated with greater depressive symptoms. Participation in the online positive mental health BMI learning program was associated with improvements in positive psychological well-being.