Importance: Complex mental health traits and life histories are not well ascertained in a hospital system. Screening unselected populations using the Barratt Impulsivity Scale and Adverse Childhood Experiences may be useful predictive tools for assessing adult disease risks. 

Objective: Determine whether two standard self-assessments are predictive of incidence and onset of disease.

Design: Retrospective cohort study. All participants answered the Healthy Nevada Project Behavioral and Mental Health Questionnaire between September 2018 and March 2024. 

Setting: Large healthcare system in Northern Nevada.

Participants: All-comer adults in Healthy Nevada Project who answered Behavioral and Mental Health Questionnaire.

Exposure: Impulsivity levels computed via Barratt’s Impulsivity Scale and retrospective self-reporting of Adverse Childhood Experiences.

Main Outcomes and Measures: Disease associations with impulsivity and Adverse Childhood Experiences were evaluated using a phenome-wide association study. Kaplan-Meier disease-free survival estimates for major depressive disorder and essential hypertension characterized differences in age of diagnosis between high and low impulsivity. 

Results: 17,482 Healthy Nevada Project participants (51.54 [16.19] age at consent; 12,458 female [71.26%]) completed the Behavioral and Mental Health Questionnaire. Adverse Childhood Experiences were significantly associated with impulsivity. Phenome-wide analyses revealed 230 significant associations (44 mental health diagnoses) with impulsivity scores. Median disease-free survival was higher in participants with Barratt Impulsivity Scales less than 33: 54.8 [53.5-56.0] years vs. 47.0 years [45.5- 48.8] for Major Depressive Disorder; 60.9 [60.4-61.4] years vs. 53.7 years [52.8-54.6] for hypertension. Participants with more than 3 Adverse Childhood Experiences and greater impulsivity scores show a 13-year difference in median disease-free survival compared to participants with low impulsivity and no Adverse Childhood Experiences for essential hypertension and Major Depressive Disorder.

Conclusions and Relevance: High impulsivity scores and Adverse Childhood Experiences are associated with many negative health outcomes and together are predictive of age at diagnosis for disorders, such as Major Depressive Disorder and essential hypertension. Simple self-assessment of complex traits and life history can be used to impact clinical risk assessments.