[Posttraumatic stress disorder in victims of sexual assault--related to depression or physical symptoms].
To clarify the clinical characteristics of mental disorders in sexual assault victims, we investigated the victims focusing on PTSD, depression, physical symptoms, and their relationships.


METHODS
Participants were 46 treatment-seeking female victims of sexual assault who consulted four hospitals, one clinic and one psychological services center, between February 2000 and April 2001. The mean +/- SD age of the participants was 28.0 +/- 8.9 years, the mean +/- SD period from the traumatic event was 94.5 +/- 88.0 months. PTSD was diagnosed and evaluated using a structured interview (Clinician-Administered PTSD Scale for DSM-IV: CAPS). Depressive symptoms were assessed using Self-rating Depression Scales (SDS). Physical symptoms were assessed using the Physical symptom scale developed by the authors.


RESULTS
Thirty-two participants (69.6%) met the criteria for PTSD in their current diagnosis, and 41 (89.1%) had the disorder at some point during their lives. SDS score and Physical symptom scale score of the PTSD group were significantly higher than those scores of the non-PTSD group. The SDS score correlated with the Avoidant-numbing score. The Physical symptoms scale score correlated with the Intrusion score and Hyperarousal score. We think that the PTSD group had the co-existing depression secondary to PTSD. Although previous studies have discussed the relationship between physical symptoms and Hyperarousal symptoms, this study suggested that physical symptoms were related to Intrusion symptoms as much as Hyperarousal symptoms. We found 2 patterns when PTSD patients reported physical symptoms related to Intrusion symptoms. The patterns were caused (1) by physiological reactivity on exposure to internal or external cues that symbolize an aspect of the traumatic event, and caused (2) by somatic reenactment symptoms.


CONCLUSIONS
We discuss the importance for clinicians to distinguish Intrusion symptoms from physical symptoms as well as Avoidant-numbing symptoms from depressive symptoms on PTSD diagnosis. Because sexual assault victims have difficulty in talking about the traumatic experience, clinicians should pay attention to these findings in developing therapeutic plans for the victims.
Hirohata
Sayuri
S
Doctoral Program in Medical Science, University of Tsukuba, (National Institute of Mental Health, National Center for Neurology and Psychiatry).
Konishi
Takako
T
Shirakawa
Miyako
M
Asakawa
Chiaki
C
Morita
Nobuaki
N
Nakatani
Yoji
Y
D000293:Adolescent; D000328:Adult; D019548:Crime Victims / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011902:Rape / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*