Health status by gastrointestinal diagnosis and abuse history.
OBJECTIVE
Standardized assessment of health status by diagnosis (functional vs. organic) and the relative influence of abuse history on health status have not been studied previously. The aim of this study was to estimate the health status and abuse history for gastrointestinal diagnoses among patients seen in a tertiary-care gastroenterology clinic and to evaluate the relative predictive effects of diagnosis and abuse history on health status.


METHODS
Standardized measures of sexual and physical abuse history and six health status measures were estimated for the patients by diagnosis. Analysis of covariance was performed to determine the relative contributions of diagnosis type and abuse history on the health status measures.


RESULTS
Patients with functional gastrointestinal diagnoses had poorer health status and a higher frequency of severe types of abuse than patients with structural diagnoses. Independent of abuse history, functional diagnosis was significantly associated with greater pain severity and psychological distress and poorer daily function. Independent of diagnosis, abuse history significantly contributed to greater pain severity, more days in bed, more psychological distress, and poorer daily function.


CONCLUSIONS
The type of diagnosis and abuse history independently contributed to the health status of this population. Therefore, medical symptoms alone may not be sufficient to understand patients' health status. Attention must also be paid to contributing psychosocial factors.
Drossman
D A
DA
Division of Digestive Diseases, Department of Medicine and Psychiatry, University of North Carolina, Chapel Hill, USA.
Li
Z
Z
Leserman
J
J
Toomey
T C
TC
Hu
Y J
YJ
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018585:Battered Women / Q000523:psychology; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008487:Medical History Taking; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D012742:Sex Offenses; D013315:Stress, Psychological / Q000209:etiology