People who suffer one or more forms of maltreatment in childhood have a higher chance of multimorbidity in later life.

New research, led by scientists at the University of Glasgow, used UK Biobank data from more than 157,000 participants to examine the link between the four forms of childhood maltreatment – physical, sexual, emotional and neglect – and the presence of multiple health conditions, known as multimorbidity, later in adult life.

Upset child sitting on the stairs

The researchers, who published their work today in the Journal of Comorbidity, found that those who had experienced all four types of maltreatment were five times as likely to have four or more long-term health conditions, than people who reported experiencing no childhood maltreatment.

When compared with no experience of childhood maltreatment, participants experiencing all four types of maltreatment were more likely to be socially isolated, and more than three times as likely to report poor self-rated health, loneliness, frailty, and chronic widespread pain. In addition, experiencing a greater number of types of childhood maltreatment was also associated with a higher prevalence of mental health conditions.

The study also found that experience of just one type of childhood maltreatment was associated with long term health conditions, including long term pain and frailty.

While experiencing multiple types of childhood maltreatment was rare, researchers found that, overall, child maltreatment affects a relatively high proportion of people, with 33% of the participants included in the study reporting at least one form of maltreatment.

Professor Frances Mair, Norie Miller Professor of General Practice at the University of Glasgow, who led the study, said: “Our findings are in keeping with the growing body of research looking at the impact of childhood adversity on future health and social outcomes. Our work, alongside other studies suggests in this area, suggests that childhood maltreatment can have consequences in later life, including the development of multimorbidity in adulthood.

“Our findings suggest people experiencing childhood maltreatment are not only at risk of higher numbers of long term health conditions in adulthood, but they are also experiencing factors that will complicate self-management and practitioner work – such as mental health problems and isolation – with implications for the resources needed to manage these patients well.”

There is a growing interest in the wider impact of Adverse Childhood Experiences (ACES), which include child maltreatment as well as domestic violence, parental abandonment, parent with a mental health condition, member of the household in prison, adult in household experiencing drug or alcohol problems. These childhood experiences are already known to have strong associations with multiple poor social and health outcomes, and result in a significant economic burden. In addition, experience of maltreatment is already associated with increased risk factors for chronic disease and a range of different physical and mental health conditions.

Dr Peter Hanlon, one of the lead authors said that, “Multimorbidity is a major global challenge. As well as ensuring adequate support for patients experiencing complex multimorbidity, the importance of prevention is paramount.”

While Dr Marianne McCallum joint lead author said: “Investing in prevention and support of early childhood adversity could result in improved health outcomes in the future. Our results add to the evidence that efforts to mitigate the impact of childhood adversity should be seen as public health measures.”

The paper, ‘Association between childhood maltreatment and the prevalence and complexity of multimorbidity: a cross sectional analysis of 157,357 UK Biobank participants’ is published in the Journal of Comorbidity. The work is funded by the Medical Research Council (MRC), The Scottish Government Chief Scientist Office and NHS Research Scotland.

ali.howard@glasgow.ac.uk or elizabeth.mcmeekin@glasgow.ac.uk / 0141 330 6557 or 0141 330 4831

First published: 19 August 2020

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