Bisphenol mixtures and adverse childhood experiences in adolescent depressive symptoms: Interaction effects and sex differences

Adolescent depression is a major public health concern influenced by environmental and psychosocial factors. While bisphenol exposure and adverse childhood experiences (ACEs) have each been linked to depression, the mental health effects of emerging bisphenol analogues and their potential interplay with ACEs remain poorly understood. This cross-sectional study included 1058 Chinese adolescents. Urinary concentrations of 14 legacy and emerging bisphenols were measured, depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and ACEs were evaluated using the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Logistic regression, Bayesian kernel machine regression, weighted quantile sum regression, and quantile g-computation were applied to evaluate individual and mixture effects, while additive interactions were assessed using the relative excess risk due to interaction (RERI). Higher urinary concentrations of BPA, BPC, and BPS were associated with increased odds of depressive symptoms, and mixture analyses consistently demonstrated positive associations between combined bisphenol exposure and depressive symptoms, with BPA, BPB, BPE, BPS, and BPC identified as the primary contributors. All ACE domains were positively associated with depressive symptoms, with emotional abuse showing the strongest association. Furthermore, significant positive additive interactions were observed between several bisphenols and emotional abuse or emotional neglect, particularly among female adolescents. These findings suggest exposure to legacy and emerging bisphenols and ACEs may independently and synergistically contribute to adolescent depressive symptoms, highlighting the importance of jointly considering environmental chemical exposures and psychosocial adversity in adolescent mental health research. Integrated assessment of these factors may improve understanding of adolescent depression and inform prevention strategies.