Self-reported and Agency-Notified Child Abuse as a Contributor to Health Anxiety in a Population-Based Birth Cohort Study at 30-Year Follow-up.

Abstract

Health anxiety is a subtype of the older term hypochondriasis, in which there is worry rather than conviction of having an illness. Information on the association between childhood maltreatment and health anxiety in adulthood often comes from retrospective questionnaires that may be subject to recall bias. There are no prospective data studies using reports to statutory agencies. We therefore assessed the effect on these outcomes at 30-year follow-up using both prospective agency notifications of child abuse and retrospective self-reports in the same birth cohort. At follow-up, there were 2458 adults with data on health anxiety as measured by the Whiteley Index. We also collected details on self-reported abuse with the Child Trauma Questionnaire and linked this to child maltreatment notifications to statutory agencies. The prevalence of self- and agency-reported maltreatment was 600 (24.4%) and 143 (5.8%), respectively. Of the participants, 235 were in the top 10% of Whiteley Index scores. On adjusted analyses, self-reported maltreatment of all types showed significant associations with increased health anxiety, while this was limited to sexual abuse in the case of agency-reported childhood maltreatment (adjusted odds ratio=2.17; 95% confidence interval=1.06-4.46; P=0.034). Effects were strongest in women. Both self- and agency-reported childhood maltreatment showed a significant association with somatic symptoms in adulthood although patterns were different and of varying degrees.