Commonly occurring adversities in families as risk factors for developing psychosocial and psychiatric morbidities: evidence from general practice

Abstract

Background Childhood adversity may lead to mental and somatic complica tions throughout life. General practitioners are equipped to identify and manage adverse events in households. The relationship between adversities and psychiatric symptoms has no been studied in primary care. Aims We investigated the relationship of common adversities in fam ilies with respect to subsequent development of psychosocial and psychiatric problems in young children. Method We analysed data from seven general practices, including parti cipants between 0 and 9 years of age. Adversity was defined a having a household member who was diagnosed with cancer, psychiatric disease or social problems. We compared these patients with controls matched for gender, age and general practice. The primary outcome was any new episode defined with a psychological and psychiatric label. Secondarily, the encounter rates at the general practices after adversity were analysed. Results Participants in both groups were followed for an average of 12 years, whereby patients with an adversity were more likely to develop psychiatric morbidities compared with matched references (odds ratio 1.38, 95% CI 1.12-1.68, P = 0.002), also revealing higher encounter rates at general practices. We found no statistically significant association between adversities in the family and increased psychosocial symptoms. Conclusions The short- and long-term consequences of exposure to negative events in childhood are of great public health importance. Our data suggest screening more proactively for consequences of commonly occurring adversities in families, as they are a risk factor for subsequent psychiatric symptoms. Enhanced consultation frequency at general practitioners following adversities should be differentiated in more detail.Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.