Alm Susanne, Låftman Sara Brolin, Bohman Hannes
Department of Criminology, Stockholm University, SE-10691, Stockholm, Sweden.
Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, SE-10691, Stockholm, Sweden.
SSM Popul Health. 2021 Apr 26;14:100807. doi: 10.1016/j.ssmph.2021.100807. eCollection 2021 Jun.
Prior research has shown that poor family relations during upbringing have long-term detrimental effects on mental health. Few previous studies have, however, focused on somatic health outcomes and studies rarely cover the life span until retirement age. The aims of the current study were, firstly, to examine the association between poor family relationships in adolescence and in-patient somatic care across the life course whilst adjusting for confounders at baseline and concurrent psychiatric in-patient care; and secondly, to compare the risks of somatic and psychiatric in-patient care across the life course.
Prospective data from the Stockholm Birth Cohort study were used, with 2636 participants born in 1953 who were followed up until 2016. Information on family relationships was collected from the participants' mothers in 1968. Annual information on in-patient somatic and psychiatric care was retrieved from official register data from 1969 to 2016.
Poisson regressions showed that poor family relationships in adolescence were associated with an increased risk of in-patient somatic care in mid- and especially in late adulthood (ages 44-53 and 54-63 years), even when controlling for the co-occurrence of psychiatric illness and a range of childhood conditions. No statistically significant association was observed in early adulthood (ages 16-43 years), when controlling for confounders. These findings are in sharp contrast to the analyses of inpatient psychiatric care, according to which the association with poor family relations was strongest in early adulthood and thereafter attenuated across the life course.
Poor family relationships in adolescence are associated with an increased risk of severe consequences for somatic health lasting to late adulthood even when controlling for confounders including in-patient psychiatric care, emphasising the potentially important role of early interventions.
先前的研究表明，成长过程中不良的家庭关系会对心理健康产生长期的有害影响。然而，以前很少有研究关注躯体健康结果，并且研究很少涵盖直至退休年龄的整个生命周期。本研究的目的，首先是在调整基线混杂因素和同期精神科住院治疗的情况下，研究青少年时期不良家庭关系与整个生命过程中住院躯体护理之间的关联；其次，比较整个生命过程中躯体和精神科住院治疗的风险。
使用斯德哥尔摩出生队列研究的前瞻性数据，对1953年出生的2636名参与者进行随访，直至2016年。1968年从参与者的母亲那里收集有关家庭关系的信息。从1969年至2016年的官方登记数据中检索有关住院躯体和精神科护理的年度信息。
泊松回归显示，青少年时期不良的家庭关系与中年尤其是成年后期（44 - 53岁和54 - 63岁）住院躯体护理风险增加有关，即使在控制精神疾病的共病情况和一系列儿童期状况时也是如此。在控制混杂因素的情况下，在成年早期（16 - 43岁）未观察到统计学上显著的关联。这些发现与住院精神科护理的分析形成鲜明对比，根据后者，与不良家庭关系的关联在成年早期最强，此后在整个生命过程中减弱。
青少年时期不良的家庭关系与持续至成年后期的躯体健康严重后果风险增加有关，即使在控制包括住院精神科护理在内的混杂因素时也是如此，这强调了早期干预的潜在重要作用。
