Selected symptoms associated with sexual and physical abuse history among female patients with gastrointestinal disorders: the impact on subsequent health care visits.
BACKGROUND
Despite a growing literature pointing to the deleterious health effects of sexual and physical abuse history, few studies provide evidence about which medical symptoms are most affected. The aim of this paper is to determine the impact of sexual and physical abuse history on a selected set of medical symptoms, and to test how such abuse, medical symptoms and functional disability may affect subsequent health care visits.


METHODS
We studied 239 women from a referral-based gastroenterology clinic; follow-up data were available on 196 of these women. All women were interviewed about sexual and physical abuse history.


RESULTS
Women with abuse history, particularly those with severe abuse, were much more likely to report somatic symptoms related to panic (e.g. palpitations, numbness, shortness of breath), depression (e.g. difficulty sleeping, loss of appetite), musculoskeletal disorders (e.g. headaches, muscle aches), genito-urinary disorders (e.g. vaginal discharge, pelvic pain, painful intercourse), skin disturbance (e.g. rash) and respiratory illness (e.g. stuffy nose). Furthermore, we found that the severity of abuse history, somatic symptoms and functional disability predicted 30% of the variance in health care visits during the subsequent year, and that the effect of abuse severity on visits was explained by abused women having more somatic symptoms and functional disability.


CONCLUSIONS
Patients' reports of abuse history, somatic symptoms and functional disability appear to be important factors in explaining the number of health care visits among a clinic sample of women with gastrointestinal disorders.
Leserman
J
J
Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill 27599-7160, USA.
Li
Z
Z
Drossman
D A
DA
Hu
Y J
YJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D016001:Confidence Intervals; D019548:Crime Victims / Q000523:psychology / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D011902:Rape / Q000523:psychology / Q000706:statistics & numerical data; D012044:Regression Analysis; D012189:Retrospective Studies; D018434:Sickness Impact Profile; D015599:Trauma Severity Indices; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*; D016387:Women's Health