A troubled youth: Relations with somatization, depression and anxiety in adulthood

Portegijs, Piet J. M.; Jeuken, Felici Mh; Horst, F. G. van der; Kraan, H. F.; Knottnerus, J. André

doi:10.1093/fampra/13.1.1

Cited by 44 publications

(36 citation statements)

References 31 publications

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“…One potential mechanism is that maltreatment conditions the child to respond to stress by increasing food intake and/or decreasing activity (Greeno & Wing, 1994;Steptoe, Wardle, Pollard, Canaan, & Davies, 1996). Childhood maltreatment is a well-established risk factor for later depression and anxiety (Mullen, Martin, Anderson, Romans, & Herbison, 1996; OakleyBrowne, Joyce, Wells, Bushnell, & Hornblow, 1995; Portegijs, Jeuken, van der Horst, Kraan, & Knottnerus, 1996), and several studies have now shown that symptoms of depression and anxiety in childhood are associated with the later development of obesity, particularly in females (Anderson, Cohen, Naumova, & Must, 2006;Goodman & Whitaker, 2002;Hasler et al, 2005;Pine, Goldstein, Wolk, & Weissman, 2001;Richardson et al, 2003). Depression and/ or anxiety resulting from maltreatment may be associated with neuro-endocrine responses that alter metabolism, activity levels, or appetite (Bjorntorp, 2001;Chrousos, 2000;Nemeroff, 2004).…”

Section: Discussionmentioning

confidence: 99%

The association between maltreatment and obesity among preschool children

Whitaker

Phillips

Orzol

et al. 2007

Child Abuse & Neglect

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Objective-To determine whether child maltreatment is associated with obesity in preschool children.Methods-Data were obtained from the Fragile Families and Child Wellbeing Study, a birth cohort study of 4898 children born between 1998 and 2000 in 20 large US cities. At 3 years of age, 2412 of these children had their height and weight measured, and mothers answered items on the ParentChild Conflict Tactics Scales about three types of child maltreatment-neglect, corporal punishment, and psychological aggression. The frequency of each type of maltreatment behavior in the prior year was analyzed using categories-ever/never for neglect and quintiles for the other 2 types of maltreatment. Child obesity was defined as measured body mass index (kg/m 2 ) ≥ 95 th percentile.Results-Eighteen percent of the children were obese, and the prevalence of any episode of neglect, corporal punishment, and psychological aggression was 11%, 84%, and 93%, respectively. The odds of obesity were increased in children who had experienced neglect (odds ratio 1.56, 95% confidence interval, 1.14-2.14), after controlling for the income and number of children in the household, the mothers' race/ethnicity, education, marital status, body mass index, prenatal smoking, and age, and the children's sex and birth weight. Neither the frequency of corporal punishment nor psychological aggression was associated with an increased risk of obesity.Conclusions-In a sample of preschool children from 20 large US cities, maternal self-report of neglectful behavior was associated with an increased risk of childhood obesity, after controlling for birth weight, maternal obesity, and multiple socioeconomic factors.

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Section: Discussionmentioning

confidence: 99%

The association between maltreatment and obesity among preschool children

Whitaker

Phillips

Orzol

et al. 2007

Child Abuse & Neglect

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“…The multiplicity of complaints and symptoms reported during our interviews, however, suggests a high degree of medicalization 35 by patients and family doctors, which is in agreement with the fi nding that patients who consult frequently have a much higher rate (40% to 50%) of physical disease than does the average attender. 17,18 The apparent inability of these patients to accommodate physical sensations or symptoms and to consistently seek out medical advice (despite such obstacles as reception staff and practice systems) suggests several possibilities. Their physical feedback mechanisms may be amplifi ed, leading to a heightened experience of their bodies and an inability to distinguish between normal and abnormal sensations.…”

Section: Discussionmentioning

confidence: 99%

“…For example, they are reported to be more likely to suffer with psychological and psychiatric problems, such as somatization, to have higher rates of physical disease, and to have poorer health beliefs when compared with those who are not frequent attenders. [16][17][18][19][20] Despite their heterogeneity, FREQUENT ATTENDERS there have been attempts to identify subgroups, such as Katon' s "distressed high utilizers," 16 and Karlsson' s 5 patient groups: patients with entirely physical illness, patients with clear psychiatric illnesses, crisis patients, chronically somatizing patients, and patients with multiple problems. 21 We decided to approach frequent attendance from another perspective, that is, what do patients themselves think about consulting a family doctor?…”

Section: Introductionmentioning

confidence: 99%

Stories from Frequent Attenders: A Qualitative Study in Primary Care

Hodgson

Smith²,

Brown³

et al. 2005

The Annals of Family Medicine

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PURPOSE Patients who make frequent offi ce visits (frequent attenders) in primary care are often considered a major burden on resources, yet we know little about their perceptions and expectations. We wanted to explore how these patients viewed their rates of consultation, what they expected from the consultation, and how they perceived their relationship with the primary health care team.METHODS Using a qualitative study design, we undertook in-depth semi-structured interviews with frequent attenders at 4 primary care practices of the Mersey Primary Care R&D Consortium in the North West of England. Participants were identifi ed on the basis of offi ce visits at least twice the mean standardized rate for 1 year and a medical assessment that these visits had no important clinical outcome. Interviews with 30 patients aged 24 to 81 years (18 men) were audiotaped and transcribed, and the text was methodically coded; data were analyzed by generating common themes. RESULTSParticipants were unable or unwilling to quantify their consultation rates. Despite the assertion by many participants that family doctors are caring, authority fi gures, there was an underlying tension between such perceptions and the apparent medical mismanagement of symptoms. Their expectations of the consultation were complex and included the presentation of old and new symptoms implicitly embedded within an illness framework. Gaining access to family doctors was generally perceived as problematic. CONCLUSIONThe criteria held by family doctors and researchers regarding the appropriate rate of consultations in primary care may not be shared by patients who attend frequently. Such patients require family doctors to acknowledge their symptoms and to provide reassurance Ann Fam Med 2005;3:318-323.

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“…Somatisation in general practice was found to be associated with damaging earlier life events, often unknown to the general practitioner [21,22]. Mollica [23] advocates the systematic assessment of the impact of traumatic life experiences in new primary care patients, especially refugees.…”

Section: Introductionmentioning

confidence: 99%

Worries are the mother of many diseases: General practitioners and refugees in the Netherlands on stress, being ill and prejudice

Feldmann¹,

Bensing

Ruijter

2007

Patient Education and Counseling

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Objective: To confront the views of refugee patients and general practitioners in the Netherlands, focusing on medically unexplained physical symptoms (MUPS). Methods: The study is based on in depth interviews with refugees from Afghanistan (n = 36) and Somalia (n = 30). Additionally, semistructured interviews were conducted with 24 general practitioners. Text fragments concerning the relationship between mental worries and health or physical ailments were subject of a secondary analysis, the results of which are presented. Results: Medically unexplained physical symptoms were a key issue for both refugees and GPs. The GPs saw MUPS as a significant part of the illness presentation by refugee patients. Refugees felt GPs were often prejudiced, too readily using their difficult background as an explanation for physical symptoms. A 'general narrative' circulating in the refugee communities undermines trust. The GPs applied different strategies in dealing with MUPS presented by their refugee patients. A 'human interest strategy' is distinguished from a 'technical strategy'. The results are discussed in the wider context of the literature on MUPS and patient satisfaction. Conclusion: No fundamental difference in paradigms was found between refugees and GPs as to the negative influence worries and bad experiences can have on health. For a fruitful cooperation to develop, based on trust, GPs need to invest in the relationship with individual refugees, and avoid actions based on prejudice. Practice implications: The importance of (a lack of) trust is underestimated in medical practice. Phenomena undermining trust are often out of sight for practitioners. Critical reflection is needed on the strategies practitioners employ to deal with MUPS. #

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A troubled youth: Relations with somatization, depression and anxiety in adulthood

Cited by 44 publications

References 31 publications

The association between maltreatment and obesity among preschool children

The association between maltreatment and obesity among preschool children

Stories from Frequent Attenders: A Qualitative Study in Primary Care

Worries are the mother of many diseases: General practitioners and refugees in the Netherlands on stress, being ill and prejudice

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