@article{ref1,
title="The relationship between adverse childhood experiences and health care use in the Manitoba IBD Cohort Study",
journal="Inflammatory bowel diseases",
year="2019",
author="Witges, Kelcie M. and Bernstein, Charles N. and Sexton, Kathryn A. and Afifi, Tracie and Walker, John R. and Nugent, Zoann and Lix, Lisa M.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: We aimed to determine the prevalence of adverse childhood experiences (ACEs) in persons with inflammatory bowel disease (IBD) and whether having ACEs was associated with health care utilization post-IBD diagnosis. <br><br>METHOD: Three hundred forty-five participants from the population-based Manitoba IBD Cohort Study self-reported ACEs (ie, physical abuse, sexual abuse, death of a very close friend or family member, severe illness or injury, upheaval between parents, and any other experience thought to significantly impacts one's life or personality) at a median of 5.3 years following IBD diagnosis. Cohort study data were linked to administrative health databases that captured use of hospitals, physician visits, and prescription drugs; use was classified as IBD-related and non-IBD-related. Mean annual estimates of health care use were produced for the 60-month period following the ACE report. Generalized linear models (GLMs) with generalized estimating equations (GEEs) with and without covariate adjustment were fit to the data. <br><br>RESULTS: The prevalence of at least 1 ACE was 74.2%. There was no statistically significant association between having experienced an ACE and health care use. However, unadjusted mean annual non-IBD-related general practitioner visits were significantly higher for participants exposed to physical and sexual abuse than those not exposed. Selected adjusted rates of IBD-related health care use were lower for participants who reported exposure to an upheaval between parents and high perceived trauma from ACEs. <br><br>CONCLUSION: The estimated prevalence of at least 1 self-reported ACE in persons with diagnosed IBD was high. Health care use among those who experienced ACEs may reflect the impacts of ACE on health care anxiety.<br><br>© 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.<p /> <p>Language: en</p>",
language="en",
issn="1078-0998",
doi="10.1093/ibd/izz054",
url="http://dx.doi.org/10.1093/ibd/izz054"
}