Childhood predictors of adult medically unexplained hospitalisations. Results from a national birth cohort study

Abstract

Background: It has been suggested that adults with medically unexplained physical symptoms experienced greater ill-health then others (either in themselves or their families) during childhood.

Aims: To test these hypotheses.

Method: We used data from the Medical Research Council (MRC) National Survey of Health and Development, a population-based cohort study established in 1946 (n = 5362). Subjects were followed from birth in 1946 until 1989 (age 43 years). As outcome, we used operationally defined medically unexplained hospital admissions at age 15-43 years. Exposure variables included childhood illness, and illness in parents during the childhood of the subjects.

Results: The risk set (n = 4603) comprised individuals still in the Survey at age 15. Ninety-five unexplained hospital admissions were identified. Subjects whose mothers reported below-average health in the father were at increased risk of subsequent unexplained admissions. Below average reported health in the mother was not associated with this increased risk. Defined physical diseases in childhood were not associated, but persistent abdominal pain at age 7-15 years was.

Conclusions: Unexplained hospital admissions are associated with certain childhood experiences of illness, but defined physical illness in childhood is not a risk factor.