Continuity of health anxiety from childhood to adolescence and associated healthcare costs: a prospective population-based cohort study
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Continuity of health anxiety from childhood to adolescence and associated healthcare costs : a prospective population-based cohort study. / Rimvall, Martin K.; Jeppesen, Pia; Skovgaard, Anne Mette; Verhulst, Frank; Olsen, Else Marie; Rask, Charlotte Ulrikka.
In: Journal of Child Psychology and Psychiatry, Vol. 62, No. 4, 2021, p. 441-448.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Continuity of health anxiety from childhood to adolescence and associated healthcare costs
T2 - a prospective population-based cohort study
AU - Rimvall, Martin K.
AU - Jeppesen, Pia
AU - Skovgaard, Anne Mette
AU - Verhulst, Frank
AU - Olsen, Else Marie
AU - Rask, Charlotte Ulrikka
PY - 2021
Y1 - 2021
N2 - BackgroundSevere health anxiety (HA) is characterized by excessive and impairing worry and preoccupation with health issues and can cause increased and unnecessary medical examinations. HA in childhood and adolescence is scarcely explored, hindering the potential for prevention and early intervention.MethodsHA was assessed in 1,278 children/youths at two time points at ages 11 and 16 years in a general population-based birth cohort. Register-based data on costs related to nonhospital-based primary and secondary somatic health services were obtained over the follow-up period. The presence of functional somatic symptoms, emotional disorders and chronic somatic illness at baseline were included as covariates.ResultsHigh HA (top 10% score) at age 11 predicted high HA at age 16 (relative risk [RR] 2.03, 95% CI: 1.26–3.31). The group with persistent HA was small (n = 17, 1.3%), resulting in broad confidence intervals. The statistical effect of HA at age 11 on HA at age 16 was heavily reduced after adjustment for sex and all covariates (RR: 1.49, 95% CI: 0.85–2.60). In the adjusted model, somatic illness at age 11 (RR: 1.91, 95% CI: 1.22–2.98) and female sex (RR: 3.33, 95% CI: 2.01–5.50) were independently associated with HA at age 16. Persistent HA was associated with approximately doubled healthcare costs compared to the group with consistently low HA. Incident HA at age 16 was associated with increased costs over follow-up. The increased costs were not explained by chronic somatic illness.ConclusionsA small subgroup of children had persistent high levels of HA from late childhood to adolescence and displayed increased healthcare costs. Female sex and chronic somatic disorders at age 11 were independent risk factors of HA at age 16. These findings provide potential means of early identification and of therapeutic levers. Further intervention development and evaluation are needed.
AB - BackgroundSevere health anxiety (HA) is characterized by excessive and impairing worry and preoccupation with health issues and can cause increased and unnecessary medical examinations. HA in childhood and adolescence is scarcely explored, hindering the potential for prevention and early intervention.MethodsHA was assessed in 1,278 children/youths at two time points at ages 11 and 16 years in a general population-based birth cohort. Register-based data on costs related to nonhospital-based primary and secondary somatic health services were obtained over the follow-up period. The presence of functional somatic symptoms, emotional disorders and chronic somatic illness at baseline were included as covariates.ResultsHigh HA (top 10% score) at age 11 predicted high HA at age 16 (relative risk [RR] 2.03, 95% CI: 1.26–3.31). The group with persistent HA was small (n = 17, 1.3%), resulting in broad confidence intervals. The statistical effect of HA at age 11 on HA at age 16 was heavily reduced after adjustment for sex and all covariates (RR: 1.49, 95% CI: 0.85–2.60). In the adjusted model, somatic illness at age 11 (RR: 1.91, 95% CI: 1.22–2.98) and female sex (RR: 3.33, 95% CI: 2.01–5.50) were independently associated with HA at age 16. Persistent HA was associated with approximately doubled healthcare costs compared to the group with consistently low HA. Incident HA at age 16 was associated with increased costs over follow-up. The increased costs were not explained by chronic somatic illness.ConclusionsA small subgroup of children had persistent high levels of HA from late childhood to adolescence and displayed increased healthcare costs. Female sex and chronic somatic disorders at age 11 were independent risk factors of HA at age 16. These findings provide potential means of early identification and of therapeutic levers. Further intervention development and evaluation are needed.
KW - Health anxiety
KW - healthcare costs
KW - longitudinal cohort
KW - childhood and adolescence
U2 - 10.1111/jcpp.13286
DO - 10.1111/jcpp.13286
M3 - Journal article
C2 - 32585055
VL - 62
SP - 441
EP - 448
JO - Journal of Child Psychology & Psychiatry
JF - Journal of Child Psychology & Psychiatry
SN - 0021-9630
IS - 4
ER -
ID: 244321093