ArticleCanadian journal of public health = Revue canadienne de sante publique2026
Childhood maltreatment and mental-physical multimorbidity: An analysis of Canadian survey data using entropy balancing.
Article in Canadian journal of public health = Revue canadienne de sante publique, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo explore childhood maltreatment as a risk factor for mental-physical multimorbidity and examine gender as an effect modifier. Explorer la maltraitance durant l'enfance en tant que facteur de risque de multimorbidité mentale-physique et voir si le genre a un effet modificateur.
methodsWe analyzed data from the 2022 Mental Health and Access to Care Survey. We described sample characteristics with unweighted counts, survey-weighted percentages, and weighted chi-square tests. Missing data were addressed via multiple imputation. Entropy balancing adjusted for age, gender, LGBTQ2+ identity, visible minority group, and immigration status and multinomial logistic regression was used to estimate associations between the number of childhood maltreatment subtypes (physical abuse, sexual abuse, and exposure to domestic violence) reported and physical (≥ 2 physical conditions but no mental), mental (≥ 2 mental conditions but no physical), and mental-physical (≥ 1 mental and physical condition) multimorbidity. Survey weights were applied during both entropy balancing and regression modeling. Effect modification by gender was examined, and sub-analyses of mental-cardiometabolic, mental-inflammatory, mental-somatic multimorbidity, and subtype-specific exposures were conducted.
resultsA total of 8967 respondents were included. Mental-physical multimorbidity increased with maltreatment: 3.4% (none, n = 4647), 6.3% (1 type, n = 2804), 10.1% (2 types, n = 1208), and 18.2% (3 types, n = 308). Adjusted odds ratios for mental-physical multimorbidity ranged from 2.15 (95% CI, 1.90-2.44) for 1 type to 8.72 (95% CI, 7.01-10.85) for 3 types compared to physical (aOR = 1.31-2.00) and mental (aOR = 1.90-3.63) multimorbidity. Men showed higher odds of mental-physical multimorbidity at high exposure (aOR = 6.14, 95% CI, 4.90-7.70 in women; aOR = 13.96, 95% CI, 9.58-20.34 in men) with varying effect sizes across disease areas.
conclusionChildhood maltreatment shows a strong dose-response association with mental-physical multimorbidity. Further research is needed to clarify gender-specific pathways.
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