Obtaining a history of sexual victimization from adolescent females seeking routine health care.
OBJECTIVE
To evaluate the clinical practice of direct physician inquiry of adolescent females during routine history taking and medical examination, with regard to their experience of childhood sexual abuse and/or assault.


METHODS
During a one-year period, a female physician directly questioned 146 consecutive female patients, aged 12-22, who were being seen for routine medical histories and physical examinations, as to whether they had ever been sexually victimized. Patients who disclosed histories of sexual victimization were immediately counseled and provided with appropriate on-site mental health referrals. Follow-up of these referrals was conducted to determine if patients complied with referrals to seek mental health services.


RESULTS
For 141 of the 146 patients, the physician was unaware of a history of sexual victimization. Of these 141 patients, thirty-two (23%) cases were identified using this clinical strategy. Almost all (93%) of these young women accepted referrals for on-site psychotherapy, and 81% kept their initial appointments for psychotherapy.


CONCLUSIONS
The routine medical history and physical examination may be an appropriate setting for health care providers to accurately and comfortably elicit a history of sexual victimization from adolescent females, and provide appropriate referrals for mental health counseling.
Diaz
Angela
A
Division o Adolescent Medicine/Mount Sinai Adolescent Health Center, Department of Pediatrics, New York, NY, USA. angela.diaz@msnyuhealth.org
Edwards
Sharon
S
Neal
Wendy P
WP
Ludmer
Pamela
P
Sondike
Stephen B
SB
Kessler
Carol
C
Medeiros
Daniel
D
Nucci
Anne T
AT
D000293:Adolescent; D000328:Adult; D003219:Confidentiality; D003376:Counseling; D019548:Crime Victims / Q000523:psychology; D005260:Female; D006801:Humans; D008487:Medical History Taking; D008605:Mental Health Services / Q000706:statistics & numerical data; D009519:New York City; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012650:Self Disclosure; D012742:Sex Offenses / Q000523:psychology