Indicators of childhood adversity in somatisation in general practice

Abstract

Objective: To identify medical and psychosocial indicators of childhood adversity in somatising patients in primary care.

Design: Retrospective questionnaires and interviews.

Setting: Primary health care in The Netherlands.

Subjects: Three-hundred-and-seventy-four somatising frequent attenders in 27 general practices between 20 and 45 years of age.

Main outcome measures: Major problems in childhood.

Results: The questionnaire on childhood problems reflected acceptable validity against a structured interview in 77 patients (correlation 0.69); however, the item "abuse" was underreported in the questionnaire. Four out of five patients reported one or more major childhood problems. Childhood adversity was indicated independently by chronic difficulties in present relations and by genital-sexual symptoms of patients.

Conclusion: When GPs want to take a more active approach towards somatisers they may show interest in the childhood and life story of patients, especially when patients are known with chronic difficulties in relations and genital-sexual symptoms.