Physical, sexual, and psychological violence in a gynaecological-psychosomatic outpatient sample: prevalence and implications for mental health.
OBJECTIVE
The main objective was to assess the prevalence of physical, sexual, or psychological violence in a cohort of patients with gynaecological symptoms who presented at a psychosomatic outpatient clinic. We assessed differences in prevalence rates of gynaecological symptoms and mental health problems in women with and without a history of experiencing violence.


METHODS
We performed a cohort study of women (n=424) who attended a psychosomatic-gynaecological outpatient clinic during a 6-year-period of time. Information about lifetime victimization, mental health status, and socio-demographic characteristics were systematically obtained through semi-structured interviews. Psychiatric diagnoses were made using questions adapted to the structured interview for DSM-IV.


RESULTS
Some form of violence was reported by 39.9%. Of the total sample, physical violence was reported in 25.2%, sexual violence in 13.0%, and psychological violence in 23.8%. Of those with a history of experiencing violence, 26.1% experienced two different kinds of violence, and 14.8% were victims of all three kinds of violence. Perpetrators of physical and psychological violence were, predominantly, the partner or the father. With respect to sexual violence, perpetrators were exclusively male, including family members or friends in more than 80% of all cases. Women with a history of experiencing violence suffered significantly more often from major depressive disorders (29.6%) than those without a history of experiencing violence (16.5%) (p<.002). Post-traumatic stress disorder (PTSD) was significantly more frequent in women with a history of experiencing violence (7.1%) (p<.001).


CONCLUSIONS
We found a high lifetime prevalence of different forms of violence toward women in our sample. Perpetrators were most often male family members, highlighting the impact of domestic violence. Our study provides evidence that women who attend a psychosomatic unit should be cautiously screened for a potential history of traumatic violent experiences.
Leithner
Katharina
K
Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. katharina.leithner@meduniwien.ac.at
Assem-Hilger
Eva
E
Naderer
Andrea
A
Umek
Wolfgang
W
Springer-Kremser
Marianne
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011602:Psychophysiologic Disorders / Q000453:epidemiology*; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult