The Relationship Between Adverse Childhood Experiences and Health Care Use in the Manitoba IBD Cohort Study.
Adolescent
Adult
Adult Survivors of Child Adverse Events
/ statistics & numerical data
Adverse Childhood Experiences
/ statistics & numerical data
Female
Follow-Up Studies
Humans
Inflammatory Bowel Diseases
/ diagnosis
Male
Manitoba
/ epidemiology
Middle Aged
Parents
/ psychology
Patient Acceptance of Health Care
/ statistics & numerical data
Prevalence
Retrospective Studies
Self Report
Stress, Psychological
/ epidemiology
Young Adult
administrative health data
adverse childhood experiences
cohort study
inflammatory bowel disease
mental health disorders
population-based
Journal
Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162
Informations de publication
Date de publication:
18 09 2019
18 09 2019
Historique:
received:
27
09
2018
pubmed:
29
3
2019
medline:
3
6
2020
entrez:
29
3
2019
Statut:
ppublish
Résumé
We aimed to determine the prevalence of adverse childhood experiences (ACEs) in persons with inflammatory bowel disease (IBD) and whether having ACEs was associated with health care utilization post-IBD diagnosis. Three hundred forty-five participants from the population-based Manitoba IBD Cohort Study self-reported ACEs (ie, physical abuse, sexual abuse, death of a very close friend or family member, severe illness or injury, upheaval between parents, and any other experience thought to significantly impacts one's life or personality) at a median of 5.3 years following IBD diagnosis. Cohort study data were linked to administrative health databases that captured use of hospitals, physician visits, and prescription drugs; use was classified as IBD-related and non-IBD-related. Mean annual estimates of health care use were produced for the 60-month period following the ACE report. Generalized linear models (GLMs) with generalized estimating equations (GEEs) with and without covariate adjustment were fit to the data. The prevalence of at least 1 ACE was 74.2%. There was no statistically significant association between having experienced an ACE and health care use. However, unadjusted mean annual non-IBD-related general practitioner visits were significantly higher for participants exposed to physical and sexual abuse than those not exposed. Selected adjusted rates of IBD-related health care use were lower for participants who reported exposure to an upheaval between parents and high perceived trauma from ACEs. The estimated prevalence of at least 1 self-reported ACE in persons with diagnosed IBD was high. Health care use among those who experienced ACEs may reflect the impacts of ACE on health care anxiety.
Sections du résumé
BACKGROUND
We aimed to determine the prevalence of adverse childhood experiences (ACEs) in persons with inflammatory bowel disease (IBD) and whether having ACEs was associated with health care utilization post-IBD diagnosis.
METHOD
Three hundred forty-five participants from the population-based Manitoba IBD Cohort Study self-reported ACEs (ie, physical abuse, sexual abuse, death of a very close friend or family member, severe illness or injury, upheaval between parents, and any other experience thought to significantly impacts one's life or personality) at a median of 5.3 years following IBD diagnosis. Cohort study data were linked to administrative health databases that captured use of hospitals, physician visits, and prescription drugs; use was classified as IBD-related and non-IBD-related. Mean annual estimates of health care use were produced for the 60-month period following the ACE report. Generalized linear models (GLMs) with generalized estimating equations (GEEs) with and without covariate adjustment were fit to the data.
RESULTS
The prevalence of at least 1 ACE was 74.2%. There was no statistically significant association between having experienced an ACE and health care use. However, unadjusted mean annual non-IBD-related general practitioner visits were significantly higher for participants exposed to physical and sexual abuse than those not exposed. Selected adjusted rates of IBD-related health care use were lower for participants who reported exposure to an upheaval between parents and high perceived trauma from ACEs.
CONCLUSION
The estimated prevalence of at least 1 self-reported ACE in persons with diagnosed IBD was high. Health care use among those who experienced ACEs may reflect the impacts of ACE on health care anxiety.
Identifiants
pubmed: 30919910
pii: 5421327
doi: 10.1093/ibd/izz054
pmc: PMC6749885
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1700-1710Subventions
Organisme : CIHR
Pays : Canada
Informations de copyright
© 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
Can J Gastroenterol Hepatol. 2016;2016:1681507
pubmed: 27795954
J Affect Disord. 2017 Apr 15;213:44-50
pubmed: 28189964
Child Abuse Negl. 2018 Nov;85:174-179
pubmed: 28784309
J Gen Intern Med. 2008 Mar;23(3):294-9
pubmed: 18204885
Health Econ. 1993 Oct;2(3):217-27
pubmed: 8275167
Inflamm Bowel Dis. 2008 Nov;14(11):1575-84
pubmed: 18512245
Clin Child Psychol Psychiatry. 2017 Apr;22(2):260-287
pubmed: 26940119
Child Psychiatry Hum Dev. 2017 Aug;48(4):610-618
pubmed: 27704299
Gen Hosp Psychiatry. 2006 Mar-Apr;28(2):108-18
pubmed: 16516060
Pediatrics. 2003 Mar;111(3):564-72
pubmed: 12612237
Pediatrics. 2012 Jan;129(1):e232-46
pubmed: 22201156
Child Abuse Negl. 2015 Jul;45:143-53
pubmed: 25846195
Arch Pediatr Adolesc Med. 2009 Dec;163(12):1135-43
pubmed: 19996051
Am J Prev Med. 2016 Mar;50(3):344-352
pubmed: 26474668
Soc Sci Med. 1988;26(3):327-32
pubmed: 3279521
Schizophr Res. 2004 Aug 1;69(2-3):167-74
pubmed: 15469190
Am J Prev Med. 2015 Mar;48(3):345-9
pubmed: 25300735
Ann Intern Med. 1990 Dec 1;113(11):828-33
pubmed: 2240898
CMAJ. 2014 Jun 10;186(9):E324-32
pubmed: 24756625
JAMA. 1999 Nov 3;282(17):1652-8
pubmed: 10553792
Inflamm Bowel Dis. 2007 Jan;13(1):33-41
pubmed: 17206637
PM R. 2014 Aug;6(8):670-80
pubmed: 24486921
J Health Soc Behav. 1983 Dec;24(4):385-96
pubmed: 6668417
JAMA. 2001 Dec 26;286(24):3089-96
pubmed: 11754674
Am J Prev Med. 2010 Jul;39(1):93-8
pubmed: 20547282
BMC Public Health. 2008 Jun 04;8:198
pubmed: 18533034
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Neurogastroenterol Motil. 2016 Aug;28(8):1252-60
pubmed: 27061107
Dig Dis. 2016;34(1-2):58-63
pubmed: 26983009
Child Abuse Negl. 2014 Mar;38(3):407-13
pubmed: 24011493
J Affect Disord. 2004 Oct 15;82(2):217-25
pubmed: 15488250
Inflamm Bowel Dis. 2009 Jul;15(7):1105-18
pubmed: 19161177
J Epidemiol Community Health. 2015 Apr;69(4):354-60
pubmed: 25538256
Ann Intern Med. 1995 Jun 15;122(12):913-21
pubmed: 7755226
Am J Gastroenterol. 2010 Sep;105(9):1994-2002
pubmed: 20372115
Am J Prev Med. 1998 May;14(4):245-58
pubmed: 9635069
Am J Gastroenterol. 2009 Jul;104(7):1754-63
pubmed: 19455122