Childhood Maltreatment and the Risk of Rheumatic Diseases Save

A UK retrospective matched open cohort study shows that children who suffered frmo abuse, neglect or domestic abuse carry a significantly increased risk of developing rheumatoid arthritis or psoriasis in later life.    

Researchers used Dexter software and over 16 million Electronic Health Records, to define two cohorts, one arm that was exposed to childhood maltreatment, and one arm that was not.  

From these, it identified 256,130 records coded for exposure before 18 years of age to abuse (physical, sexual, or emotional), neglect, domestic abuse, either by the GP, or codes relating to social services involvement.  The control group consisted of 712,478 records which were matched on age, sex, indices of deprivation, and GP surgery.  

The records from these two cohorts were checked for diagnostic codes for immune-mediated inflammatory disorders (rheumatoid arthritis, psoriasis, coeliac disease, multiple sclerosis, inflammatory bowel disease, and systemic lupus erythematosus) over a 26-year period running from 1995 to 2021.  

The findings showed the childhood maltreatment cohort had a significantly increased risk for: 
•    Rheumatoid Arthritis: 11.19/100,000 patient years vs 7.77/100,000 patient years (p=0.003)
•    Psoriasis: 152.79/100,000 patient years vs 128.74/100,000 patient years (p<0.001). 

The increase in risk was significant for both diseases, and the association was more pronounced in women than in men.  
The study was led by Dr Liam Snook from the University of Birmingham.  Its senior author, Professor Joht Singh Chandan, Clinical Professor of Public Health and Health Inequalities Lead at Birmingham Health Partners, commented: "As far as we’re aware, this is the first matched cohort longitudinal study to investigate the relationship between childhood maltreatment and immune-mediated inflammatory disorders (IMIDs) in later life.”

The uniqueness of the study lies in the Dexter software, can rapidly inspect huge databases of longitudinal data with billions of datapoints, delivering reproducible, accurate and transparent results.  

Professor Chandan, who is also Head of Customer Success at Dexter software, points out two impacts from studies that use this type of ‘big data’.  He said: “For scientists, the study identifies an area that warrants further investigation into biological pathways that may link early life stressors to these two immune diseases.  For public health professionals, it paints a better picture of the patient.”  

“This approach can be used to identify inequalities in healthcare, alerting healthcare providers and delivers to patient groups that need specific attention, and ultimately allocating healthcare resources to meet those with the greatest need. In the future, we plan to use this approach to look at further longitudinal datasets in crime, social care, and mental health care.”