O C Schmahl1, H W Jeuring1, I Aprahamian2, P Naarding3, R M Marijnissen1, G J Hendriks4, M Fluiter5, D Rhebergen6, A Lugtenburg7, M W Lammers8, R H S van den Brink1, R C Oude Voshaar9. 1. University of Groningen, University Medical Center Groningen, Rob Giel Research center (RGOc), The Netherlands. 2. University of Groningen, University Medical Center Groningen, Rob Giel Research center (RGOc), The Netherlands; Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Internal Medicine Department, Jundiaí Medical School, Jundiaí, Brazil. 3. GGNet Mental Health, Division of Old Age Psychiatry, Warnsveld & Apeldoorn, The Netherlands. 4. Behavioural Science Institute, Radboud University & Pro Persona Institute for Integrated Mental Health Care, Nijmegen, The Netherlands. 5. Mental Health Center GGZ Noord-Holland Noord, Heerhugowaard, The Netherlands. 6. Mental Health Center GGZ Centraal, Ermelo, The Netherlands & Psychiatry, Amsterdam UMC, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, Netherlands. 7. Mental Health Center GGZ Drenthe, Assen, The Netherlands. 8. Mediant Mental Health Center, Enschede, The Netherlands. 9. University of Groningen, University Medical Center Groningen, Rob Giel Research center (RGOc), The Netherlands. Electronic address: r.c.oude.voshaar@umcg.nl.
Abstract
OBJECTIVES: Frailty marks an increased risk for adverse health outcomes. Since childhood trauma is associated with the onset of physical and mental health diseases during the lifespan, we examined the link between childhood trauma and multidimensional frailty. METHOD: A cross-sectional study embedded in a clinical cohort study (ROM-GPS) of older (≥60 years) patients (n=182) with a unipolar depressive-, anxiety- and/or somatic symptom disorder according to DSM-criteria referred to specialized geriatric mental health care. Frailty was assessed with the Tilburg Frailty Indicator (TFI), comprising a physical, psychological, and social dimension. Physical, sexual and psychological abuse and emotional neglect before the age of 16 years was measured with a structured interview. RESULTS: Of 182 patients, 103 (56.6%) had experienced any childhood trauma and 154 (84.6%) were frail (TFI sum score ≥5). Linear regression analyses, adjusted for lifestyle, psychological and physical-health factors, showed that the presence of any type of childhood trauma was not associated with the TFI sum score, however when considered separately, physical abuse was (ß=0.16, p=.037). Regarding the specific frailty dimensions, any childhood trauma was associated with social frailty (ß=0.18, p=.019), with emotional neglect as main contributor. CONCLUSION: These findings demonstrate a complex link between different types of childhood trauma and multidimensional frailty among older psychiatric patients. Regarding the three dimensions of frailty, social frailty seems most affected by childhood trauma. This may have been underestimated until now and should receive more attention in clinical care and future research.
OBJECTIVES: Frailty marks an increased risk for adverse health outcomes. Since childhood trauma is associated with the onset of physical and mental health diseases during the lifespan, we examined the link between childhood trauma and multidimensional frailty. METHOD: A cross-sectional study embedded in a clinical cohort study (ROM-GPS) of older (≥60 years) patients (n=182) with a unipolar depressive-, anxiety- and/or somatic symptom disorder according to DSM-criteria referred to specialized geriatric mental health care. Frailty was assessed with the Tilburg Frailty Indicator (TFI), comprising a physical, psychological, and social dimension. Physical, sexual and psychological abuse and emotional neglect before the age of 16 years was measured with a structured interview. RESULTS: Of 182 patients, 103 (56.6%) had experienced any childhood trauma and 154 (84.6%) were frail (TFI sum score ≥5). Linear regression analyses, adjusted for lifestyle, psychological and physical-health factors, showed that the presence of any type of childhood trauma was not associated with the TFI sum score, however when considered separately, physical abuse was (ß=0.16, p=.037). Regarding the specific frailty dimensions, any childhood trauma was associated with social frailty (ß=0.18, p=.019), with emotional neglect as main contributor. CONCLUSION: These findings demonstrate a complex link between different types of childhood trauma and multidimensional frailty among older psychiatricpatients. Regarding the three dimensions of frailty, social frailty seems most affected by childhood trauma. This may have been underestimated until now and should receive more attention in clinical care and future research.