Citation

Witges KM, Bernstein CN, Sexton KA, Afifi T, Walker JR, Nugent Z, Lix LM. Inflamm. Bowel Dis. 2019; ePub(ePub): ePub.

Affiliation

Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1093/ibd/izz054

PMID

30919910

Abstract

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.

© 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Language: en

Keywords

administrative health data; adverse childhood experiences; cohort study; inflammatory bowel disease; mental health disorders; population-based