Childhood Maltreatment Associated With Arthritis in Adulthood

Childhood maltreatment was associated with an increased risk for adulthood arthritis, according to study data published in Arthritis Care & Research.

Researchers extracted data from the mental health section of the 2012 Canadian Community Health Survey, a cross-sectional survey of 21,889 respondents aged ≥18 years. The survey captured severity and frequency of childhood physical abuse, childhood sexual abuse, and childhood exposure to intimate partner violence. Participants then reported chronic conditions as diagnosed by a health professional, including arthritis. Additional covariates included sociodemographic characteristics, health risk variables, and diagnosis of any mental disorders. Multivariate logistic regression analysis was performed to assess any associations between childhood abuse and arthritis in adulthood.

A total of 17.5% of respondents reported arthritis. A higher prevalence of arthritis was observed in those who reported severe and/or frequent childhood physical abuse (32%), sexual abuse (27%), or exposure to intimate partner violence (27%). After controlling for age, sex and other sociodemographic variables, these associations remained significant. After controlling for all covariates, including mental disorders and other chronic conditions, severe and/or frequent childhood physical abuse and frequent childhood exposure to intimate partner violence maintained a significant association with arthritis.

Results suggested a dose-response relationship between childhood maltreatment and adulthood arthritis, in that those exposed to severe and/or frequent childhood maltreatment were most likely to report arthritis in adulthood. Specifically, individuals who reported severe and frequent childhood physical abuse had an odds of arthritis twice that of the general population (adjusted odds ratio [aOR], 2.0; 95% CI, 1.2-3.5). Those who reported severe[ALH1]  childhood physical abuse alone also had an increased odds of arthritis compared with control participants (aOR, 1.4; 95% CI, 1.1-1.7). Frequent childhood exposure to intimate partner violence (>10 times) was also associated with an increased risk for arthritis in the fully adjusted model (aOR, 1.6; 95% CI, 1.1-2.4).

These results strongly suggest a correlation between childhood maltreatment and adulthood arthritis, particularly among those who experienced severe and/or frequent abuse. This relationship remained significant after adjusting for co-occurring chronic conditions and other health risk factors, including obesity, smoking status, and physical activity. Investigators hypothesized that chronic inflammation and immune and metabolic abnormalities, which are associated with childhood maltreatment, may affect the pathogenesis of osteoarthritis. Future research is necessary to elucidate the precise mechanism through which childhood maltreatment may affect arthritis development and risk.

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Reference

Badley EM, Shields M, O’Donnell S, Hovdestad WE, Tonmyr L. Childhood maltreatment as a risk factor for arthritis: Findings from a population-based survey of Canadian adults [published online October 17, 2018]. Arthritis Care Res. doi: 10.1002/acr.23776