Association between childhood maltreatment and the prevalence and complexity of multimorbidity: a cross-sectional analysis of 157,357 UK Biobank participants

Hanlon, P. , McCallum, M. , Jani, B. D. , McQueenie, R., Lee, D. and Mair, F. S. (2020) Association between childhood maltreatment and the prevalence and complexity of multimorbidity: a cross-sectional analysis of 157,357 UK Biobank participants. Journal of Comorbidity, 10, pp. 1-12. (doi: 10.1177/2235042X10944344)

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Abstract

Background: Child maltreatment is associated with long-term conditions (LTCs) in adulthood. Its relationship to multimorbidity (≥2 LTCs) is less clear. We explore the relationship between child maltreatment, multimorbidity and factors complicating management. Methods: Cross-sectional analysis of 157,357 UK Biobank participants. Experience of four maltreatment types (physical/sexual/emotional/neglect) was identified. We explored the relationship between type, number and frequency of maltreatment and LTC count (0, 1, 2, 3, ≥4) using multinomial logistic regression. Binary logistic regression assessed the relationship between maltreatment and self-rated health, loneliness, social isolation, frailty and widespread pain in those with multimorbidity, adjusting for sociodemographics and lifestyle factors. Results: 52,675 participants (33%) experienced ≥1 type of maltreatment; 983 (0.6%) experienced all four. Type, frequency and number of types of maltreatment were associated with higher LTC count. People experiencing four types of maltreatment were 5 times as likely to have a LTC count of ≥4 as those experiencing none (odds ratio (OR): 5.16; 99% confidence interval (CI): 3.77-7.07). Greater number of types of maltreatment was associated with higher prevalence of combined physical/mental health LTCs (OR: 2.99; 99% CI: 2.54–3.51 for four types of maltreatment). Compared to people who reported no maltreatment, people experiencing all four types of maltreatment were more likely to have poor self-rated health (OR: 3.56; 99% CI: 2.58–4.90), loneliness (OR: 3.16; 99% CI: 2.17–4.60), social isolation (OR: 1.45; 99% CI: 1.03–2.05), widespread pain (OR: 3.19; 99% CI: 1.87–5.44) and frailty (OR: 3.21; 99% CI: 2.04–5.05). Conclusion: Peoplewith a history of maltreatment have higher LTC counts and potentially more complicated management needs reinforcing calls for early intervention.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Jani, Dr Bhautesh and Lee, Professor Duncan and Hanlon, Dr Peter and Mair, Professor Frances and McQueenie, Dr Ross and McCallum, Dr Marianne
Authors: Hanlon, P., McCallum, M., Jani, B. D., McQueenie, R., Lee, D., and Mair, F. S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Science and Engineering > School of Mathematics and Statistics > Statistics
Journal Name:Journal of Comorbidity
Publisher:SAGE Publications
ISSN:2235-042X
ISSN (Online):2235-042X
Published Online:19 August 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Journal of Comorbidity 10: 1-12
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
305232Understanding prevalence and impact of frailty in chronic illness and implications for clinical managementFrances MairMedical Research Council (MRC)MR/S021949/1HW - General Practice and Primary Care
307220Multimorbidity in the context of Socioeconomic deprivation: a mixed methods exploration of how Community and Individual factors interact to influence patient capacity to manage Multimorbidity (SCIM)Sara MacDonaldChief Scientist Office (CSO)CAF/19/05HW - General Practice and Primary Care