Mertz Line Granild Bie, Carstensen Tina Birgitte Wisbech, Frostholm Lisbeth, Ørnbøl Eva, Rask Charlotte Ulrikka
The Research Unit, Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Aarhus, Denmark.
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
J Psychosom Res. 2023 Nov;174:111496. doi: 10.1016/j.jpsychores.2023.111496. Epub 2023 Sep 11.
Childhood adverse life events, in particular illness-related events, have been proposed as a risk factor for development of health anxiety.
To examine: 1) The association between accumulated early adverse life events and health anxiety in adulthood and 2) The influence of specific types of life events, i.e., illness, injury, loss, and the impact of their exposure time on health anxiety in adulthood.
A population-based, cross-sectional study including 7454 participants from the Danish study of Functional Disorders (DanFunD). Health anxiety was assessed with Whiteley-6-R and early adverse life events with the Cumulative Lifetime Adversity Measure. Caseness was defined as a Whiteley-6-R score ≥ 90%ile. Generalised linear models were used to estimate the association with relative risk (RRa, adjusted for sociodemographics).
A cumulative effect was found for each additional adverse life event with 8.03% increased risk of health anxiety. Two categories were associated with a higher risk: violence (RRa = 1.65, 95% CI: 1.37-1.99, P < 0.001) and relationship stress (RRa = 1.34; 95% CI: 1.15-1.57, P < 0.001). Respondents with self-reported childhood illness were also more likely to report health anxiety (RRa = 1.52, 95% CI 1.11-2.09, P = 0.009). Timewise, health anxiety seemed associated with illness during school age and injury during adolescence.
Accumulated adverse life events, early exposure to specific categories and specific health-related life events were associated with self-reported health anxiety in adulthood. Our findings provide new knowledge on the potential role of early life events in health anxiety which could inform early intervention.
儿童期不良生活事件，尤其是与疾病相关的事件，已被提出是健康焦虑症发展的一个风险因素。
研究：1）成年期累积的早期不良生活事件与健康焦虑症之间的关联；2）特定类型生活事件，即疾病、伤害、丧失，以及它们的暴露时间对成年期健康焦虑症的影响。
一项基于人群的横断面研究，纳入了来自丹麦功能性障碍研究（DanFunD）的7454名参与者。使用怀特利-6-R量表评估健康焦虑症，使用累积终生逆境量表评估早期不良生活事件。病例定义为怀特利-6-R量表得分≥第90百分位数。使用广义线性模型估计与相对风险（RRa，经社会人口统计学因素调整）的关联。
发现每增加一个不良生活事件都有累积效应，健康焦虑症风险增加8.03%。两类事件与较高风险相关：暴力（RRa = 1.65，95%置信区间：1.37 - 1.99，P < 0.001）和人际关系压力（RRa = 1.34；95%置信区间：1.15 - 1.57，P < 0.001）。自我报告有儿童期疾病的受访者也更有可能报告健康焦虑症（RRa = 1.52，95%置信区间1.11 - 2.09，P = 0.009）。从时间上看，健康焦虑症似乎与学龄期疾病和青春期伤害有关。
累积的不良生活事件、早期暴露于特定类别以及与健康相关的特定生活事件与成年期自我报告的健康焦虑症相关。我们的研究结果为早期生活事件在健康焦虑症中的潜在作用提供了新知识，可为早期干预提供参考。
