Stressful and potentially traumatic events and healthcare utilization: the 7(th) Tromsø survey

压力和潜在创伤事件与医疗保健利用:第七次特罗姆瑟调查

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Abstract

BACKGROUND: Stressful and potentially traumatic life events (SLEs/PTEs) can have a profound negative impact on the individual's mental and physical wellbeing and health. Consequently, an association of SLEs/PTEs with increased healthcare utilization has been found. However, most studies have been conducted in selected samples (e.g., veterans), and there is a paucity of studies in the general population. The present study examined the associations between SLEs/PTEs and the utilization of healthcare services in the general population using data from the seventh survey of the Tromsø study (Tromsø7). METHODS: The sample comprised 20,069 participants aged 40 years and above (52.5% female, mean age 57.3 years, SD = 11.4 years) who completed measures of SLE/PTE exposure in childhood/adolescence and adulthood (including a question about mental preoccupation with SLEs/PTEs), utilization of a variety of healthcare services (general practitioner, medical specialist, hospital, emergency room, mental health services, physiotherapist, and complementary and alternative medicine provider) in the previous year, and self-reported feeling of being anxious or depressed. RESULTS: The results showed that SLE/PTE exposure is associated with an increased use of all healthcare services, especially mental health professionals. Exposure to physical and emotional neglect in childhood/adolescence, violence, and sexual abuse showed the strongest associations with the utilization of mental health services. The strength of the associations with health service utilization increased with the number of SLEs/PTEs. Finally, mental preoccupation with the event(s) moderated the associations between SLE/PTE exposure and the utilization of healthcare services but not self-reported feeling of being anxious or depressed. CONCLUSION: It is concluded that the prevention of SLEs/PTEs and screening for SLE/PTE exposure in healthcare services to provide trauma-informed care should be a prioritized public health focus.

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