title: The relationship of childhood sexual abuse and depression with somatic symptoms and medical utilization.
abstract: BACKGROUND
  Previous research suggests that childhood sexual abuse is associated with high rates of retrospectively reported medical utilization and medical problems as an adult. The goal of this study was to determine if abused females have higher rates of medical utilization using self-report and objective measures, compared with non-abused females. A further goal was to determine whether findings of prior research would be replicated when childhood physical abuse level was controlled. This study also examined the moderating impact of depressed mood on current health measures in this population.
  
  
  METHODS
  Six hundred and eight women recruited from a health maintenance organization completed self-report measures of health symptoms for the previous month and doctor visits for the previous year. Objective doctor records over a 2 year period were examined for a subset of 136 of these women.
  
  
  RESULTS
  Results showed significantly more self-reported health symptoms and more self-reported doctor visits in abused participants compared with those who reported no childhood history of sexual abuse. Objective doctor visits demonstrated the same pattern with abused participants exhibiting more visits related to out-patient surgery and out-patient internal medicine. In addition, persons who were both sexually abused and depressed tended to visit the emergency room more frequently and to have more in-patient internal medicine and ophthalmology visits than sexually abused participants who reported low depressed mood and non-abused controls.
  
  
  CONCLUSIONS
  These results replicate prior studies and suggest that current depression may moderate the relationship between sexual abuse and medical problems in adulthood.
authors.affiliation: Department of Psychology, Pennsylvania State University, University Park 16802-3103, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Newman
authors.forename: L
authors.initials: L
authors.lastname: Clayton
authors.forename: A
authors.initials: A
authors.lastname: Zuellig
authors.forename: L
authors.initials: L
authors.lastname: Cashman
authors.forename: B
authors.initials: B
authors.lastname: Arnow
authors.forename: R
authors.initials: R
authors.lastname: Dea
authors.forename: C B
authors.initials: CB
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data*; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D014600:Utilization Review