title: Childhood sexual abuse is associated with physical illness burden and functioning in psychiatric patients 50 years of age and older.
abstract: OBJECTIVE
  To examine the association of childhood sexual abuse (CSA) with cumulative illness burden, physical function, and bodily pain (BP) in a sample of male and female psychiatric patients >or=50 years of age. Previous research on the health consequences of sexual abuse has focused on nonpsychiatric samples of younger-age adults, especially women. The health implications of abuse for mixed-gender samples of older psychiatric patients have not been explored.
  
  
  METHODS
  Participants were 163 patients with primary mood disorders. Sexual abuse histories were collected via patient self-report, as was BP. The measure of medical illness burden was based on chart review. Clinical interviewers rated physical function, using the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) scales. Linear and logistic regressions examined the association between CSA and health outcomes.
  
  
  RESULTS
  As hypothesized, severe childhood sexual abuse was associated with higher cumulative medical illness burden, worse physical function, and greater BP. Comparisons of regression coefficients revealed that severe CSA's influence on illness burden is roughly comparable to the effects of adding 8 years of age. For ADL impairment and BP, the effects are comparable to adding 20 years of age.
  
  
  CONCLUSIONS
  Strong relationships exist between CSA and medical illness burden, function, and pain among psychiatric patients >or=50 years of age. These relationships cannot be ascribed to shared method variance. Early detection of patients' abuse histories could inform targeted interventions to prevent or decelerate the progression of morbidity in this high-risk group.
authors.affiliation: Department of Psychiatry, Rochester Center for Mind-Body Research, University of Rochester, School of Medicine and Dentistry, 300 Crittenden Blvd., Box PSYCH, Rochester, New York 14642, USA. Nancy_Talbot@urmc.rochester.edu
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Talbot
authors.forename: Ben
authors.initials: B
authors.lastname: Chapman
authors.forename: Yeates
authors.initials: Y
authors.lastname: Conwell
authors.forename: Kelly
authors.initials: K
authors.lastname: McCollumn
authors.forename: Nathan
authors.initials: N
authors.lastname: Franus
authors.forename: Stefan
authors.initials: S
authors.lastname: Cotescu
authors.forename: Paul R
authors.initials: PR
authors.lastname: Duberstein
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D015897:Comorbidity; D004194:Disease; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000453:epidemiology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors