The later-life health effects of stressful childhood experiences were examined by researchers at University College Cork in a study involving 2,047 adults aged 50-69.
Lead researcher Carol Sinnott, who runs a GP surgery in Waterford, said she sees patients in her practice everyday with chronic diseases such as heart disease, diabetes and depression whose needs go “over and above” having their disease managed.
“When I am managing patients with multimorbidity [two or more chronic diseases], it’s not just about the diseases and the multiple medications, it’s also about a range of social factors and psychological factors that they bring to the practice with them,” said Dr Sinnott.
Her UCC research, which is funded by the Health Research Board (HRB) and published in the journal Family Practice, is the first study to demonstrate a significant association between adverse childhood experiences and multiple chronic diseases.
Adverse childhood experiences included whether a person was threatened often; beaten; sexually abused; not had enough to eat; or had parents who were incarcerated or who had addiction issues.
Dr Sinnott said a number of theories exist to explain the relationship between negative childhood experiences and multimorbidity. One is that early manifestations of childhood adversity, such as failure to thrive or neurodevelopmental stress, may initiate the bodily changes that pave the way to development of a particular disease or diseases.
Another theory is that traumatic childhood issues may go unaddressed within conventional medical care — i.e. patients presenting with vague symptoms undergo a battery of tests leading to diagnoses that reinforce their list of illnesses without getting to the source of their problems.
Dr Sinnott said the results of her research had implications for both public health and GPs. From a public health perspective, it highlighted the need for early intervention targeting harmful coping strategies, such as smoking and alcohol and drug abuse, of survivors of childhood abuse and neglect. This could yield future benefits in chronic disease prevention.
From a GP perspective, the findings “reinforce the need for comprehensive, patient-centred care which takes into account the psychosocial causes and consequences of multi-morbidity”, Dr Sinnott said.
“Often GPs are concentrating so hard on following the guidelines [for treating disease] that sometimes the patient can get lost in the mix,” said Dr Sinnott.