Childhood experience and health care use in adulthood: nested case--control study.
BACKGROUND
Few studies have considered the role of childhood experiences in adult health care use.


OBJECTIVE
To examine the hypotheses that individuals frequently attending primary care report childhood adversities and illness exposures more commonly than the remainder of patients and that any association is independent of adult psychiatric disorder.


METHODS
A nested case-control study was carried out in a single general practice in Manchester, UK. Fifty frequent attenders (randomly selected from adult patients in the top decile of consultation frequency) and fifty normal attenders (randomly selected from the remainder of adult patients) underwent a structured psychiatric interview and a detailed, semi-structured interview of childhood experience.


RESULTS
There was a strong association between frequent attendance and childhood experiences. Multivariate analysis suggested that reported childhood illness exposures and reports of childhood adversity were each associated independently with adult consultation behaviour, even after adjustment for adult psychiatric disorder.


CONCLUSIONS
Interventions for high users of health care may need to address childhood experiences of illness and childhood adversities, as well as adult psychiatric disorder.
Department of Psychiatry, Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. nav.kapur@man.ac.uk
Navneet
N
Kapur
Isabelle
I
Hunt
Gary
G
Macfarlane
John
J
McBeth
Francis
F
Creed
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D004739:England; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012044:Regression Analysis