07 January 2010

Abuse as kid = chronic pain as adult

Children who were physically or emotionally abused or neglected are more likely to develop migraines and other chronic pain conditions as adults, a new study finds.


Children who were physically or emotionally abused or neglected are more likely to develop migraines and other chronic pain conditions as adults, a new study finds.

According to the researchers, their study and others have found stress caused by abuse can alter children's brains, making them more likely to develop chronic pain from such conditions as irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, interstitial cystitis and arthritis.

"Stressful events in childhood, such as abuse, can alter the body's stress response permanently and predispose to a wide variety of medical and psychiatric conditions in adulthood," said the study's lead researcher, Dr Gretchen E. Tietjen, professor and chairwoman of neurology and director of the Headache Treatment and Research Program at the University of Toledo Medical Centre in Ohio.

It is not uncommon, she said, for people who've been abused to have a variety of debilitating conditions, including migraine.

Worse the abuse, worse the migraine

"The linking of these comorbidities may be through abuse-mediated brain changes occurring early in life," Tietjen said. "Understanding the physiology of abuse's effects on the brain over the life span may lead to prevention or more effective treatment of migraine and associated conditions."

She was quick to note, however, that not all abused children develop migraines and not everyone who suffers from migraines or any other chronic painful condition was abused.

But those with a history of abuse "are more likely to have the worst cases of migraine," she said. "They are the ones most likely to have a lot of the other pain conditions." The findings are reported in Headache: The Journal of Head and Face Pain.

How the study was done

For the study, Tietjen's group collected data on 1 348 people with migraines who were seen at 11 outpatient headache centres. About 58% reported being physically, sexually or emotionally abused or physically or emotionally neglected during childhood. Also, 61% reported having at least one painful condition other than migraine.

Those who had been abused or neglected as children were significantly more likely to suffer from other chronic pain conditions than were people who had not been abused as children, the researchers found.

"Childhood abuse, especially emotional abuse and neglect, is very common in the population of persons seeking help for headache," Tietjen said. "Childhood abuse is linked to high frequency of headache in adults, and to headache-related disability. Persons with migraine who have been abused are more likely to suffer from depression, anxiety and from chronic stress-related pain conditions."

The researchers noted that different types of abuse appeared to result in different conditions. For example, physical abuse was linked with arthritis, whereas emotional abuse was associated with irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia and arthritis, Tietjen said.

Effects of abuse long-lasting

Physical neglect was linked to an increased likelihood of irritable bowel syndrome, chronic fatigue syndrome, interstitial cystitis and arthritis.

Women who suffered physical abuse or neglect as children were also more likely to have endometriosis and uterine fibroids. Emotional abuse was linked to both conditions as well, but emotional neglect was associated with uterine fibroids alone, the study found.

Dr Walter Lambert, an associate professor and medical director of the child protection team at the University of Miami Miller School of Medicine, said that "adverse childhood events have significant long-term health risks in adulthood."

"It does not surprise me that people who reported emotional abuses would have more chronic headaches and migraines," he added.

Lambert also agreed that stress in childhood can change pathways in the brain, with neglect being the worst. Children can take only so much stress before it begins to affect their growing brain, he explained.

"As human beings," Lambert said, "we need nurturing -- both physical nurturing and emotional nurturing -- to flourish." Society needs to find ways to promote nurturing and stable environments for children to prevent maltreatment, he added.  - (HealthDay News, January 2010)





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