Marginal impact of psychosocial factors on multimorbidity: results of an explorative nested case-control study

This study examines differences between subjects with zero, one or two or m ore new diseases in a period of three years, with regard to demographic cha racteristics, socioeconomic status, life style, medical family history and current diseases in the family, psychological and sociological characterist ics. This was studied using a primary care based nested case-control study. Data were available from 3745 cases and controls, all aged 20 years and ol der. All subjects were sampled from the Registration Network Family Practic es, which is a computerised continuous primary care database. Cases were de fined as subjects with new multimorbidity (two or more new diseases) regist ered in period of three years and two groups of controls were operationalis ed as subjects with either one or no new diseases registered in the same pe riod. Determinants were assessed by means of a postal questionnaire. Increa sing age, higher number of previous diseases and low socioeconomic status w ere strongly associated with both morbidity and multimorbidity. After adjus tment for these basic variables, the occurrence of multimorbidity was more frequent among subjects who did not report (volunteer) work or study, who h ad an active coping style, a high occupational class and an external locus of control. Profiles for subjects at risk for morbidity and multimorbidity seem to differ. (C) 2000 Elsevier Science Ltd. All rights reserved.