En blogg fra Allmennmedisinsk forskningsenhet (AFE) Trondheim

Adverse Childhood Experiences: When Will the Lessons of the ACE Study Inform Societal Care?

Anna Luise Kirkengen har bidratt til en ny rapport «Adverse Childhood Experiences: When Will the Lessons of the ACE Study Inform Societal Care?» som Joshua Kendall har laget, og som omtaler betydningen av den kjente ACE- studien og hvilken innvirkning denne kunnskapen har hatt for helsetjenesten i ulike land. Rapporten ble publisert 26.mai 2019. Under avsnittet «Norway Turns to ACE-based Health Care» gjengis et intervju med Kirkengen og det referes til hennes viktige arbeid på sammenhenger mellom krenkelser og helseplager, og hvordan dette kan sees i sammenheng med resultatene fra ACE-studien.

Utdrag fra rapporten:

«Back in the mid-1980s, when Felitti was struggling with the mystery of what ailed Patty in San Diego, some 6000 miles away in Norway, Anna Luise Kirkengen was also stumbling upon the connection between a history of trauma and various medical ills.

Trained in medicine in her native Germany, Kirkengen moved to Norway where she set up shop as a general practitioner in the city of Oslo—at that time, the only female GP in her part of town. Soon 90% of her patients were women. “I began hearing repeated stories from women about being violated as children. And there was nothing about it in textbooks. It seemed like the past was still present in many of the medical complaints that my patients spoke about,” she said.

Kirkengen, who today teaches in the department of public health and nursing at the Norwegian University of Science and Technology in Trondheim, decided to go back to university to obtain her doctorate. Although she was not then aware of the ACE study, she was formulating similar conclusions.  She turned her dissertation into the 2001 book, Inscribed Bodies: Health Impact of Child Sexual Abuse. Felitti reviewed the book a year later, and they have been close collaborators ever since. “His work is a mirror of my own philosophical reflections,” Kirkengen said.

For the past couple of decades, Kirkengen has fought to convince colleagues in the medical community about the scientific basis of her findings. “This knowledge is now seeping into public health and general medicine in Norway. There are now courses on the effects of childhood trauma for doctors enrolled in residency programs in family medicine. And by 2020, this training will be required for all doctors who want to work in family medicine for municipalities throughout Norway.”

Some family doctors in Norway, she said, have begun routinely referring their patients to mental health clinicians—psychologists, physiotherapists and body workers—who can help them address the long-terms effects of trauma. “Conditions like depression are inscribed into the body, and medication is ineffective. These patients need help reorganizing their way of being, and this is not done in psychiatry.”

Norway has a generous publicly-funded health insurance system, which typically covers most of the cost of these services. “This behavior is not yet mainstream among my primary care colleagues, but there is a growing awareness, and family doctors can play a key role in setting up these relationships with psychologists and physiotherapists,” she said.

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