title: Traumatic experiences in childhood and the risk of arthritis: a prospective cohort study.
abstract: BACKGROUND
  Recent data suggest that psychosocial factors, including childhood and adulthood stressors, may play a significant role in the development of chronic musculoskeletal pain and other symptoms. The purpose of this study was to determine if traumatic experiences in childhood are associated with an increased risk of self-reported arthritis later in life.
  
  
  METHODS
  We used longitudinal data (N=9,159) from the first 3 cycles of the National Population Health Survey (NPHS) in Canada. New cases of arthritis were identified using an interviewer-administered questionnaire. Psychological trauma in childhood or adolescence was measured by a 7-item questionnaire asking about physical abuse, fearful experiences, hospitalization, being sent away from home, and 3 types of parental disturbance. The effects of trauma were examined in a multivariable discrete-time proportional hazards model.
  
  
  RESULTS
  The incidence of self-reported arthritis was 27.1 per 1,000 person-years. We found a relative risk of 1.17 (95% CI=0.92, 1.48) for one traumatic event and 1.27 (95% CI=0.99, 1.62) for two or more traumatic events. Independent effects were observed for prolonged hospitalization (HR=1.33, 95% CI=1.05, 1.68) and being very scared (HR=1.29, 95% CI=1.02, 1.62). In subgroup analyses, no significant interactions were found between trauma and sex, socio-economic status, or baseline health.
  
  
  CONCLUSIONS
  In this large prospective study, we found a moderate increase in the risk of arthritis among persons reporting multiple traumatic experiences in childhood.
authors.affiliation: Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC. jkopec@arthritisresearch.ca
authors.forename: Jacek A
authors.initials: JA
authors.lastname: Kopec
authors.forename: Eric C
authors.initials: EC
authors.lastname: Sayre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000453:epidemiology* / Q000523:psychology; D002170:Canada / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*