title: Sexual abuse and lifetime diagnosis of somatic disorders: a systematic review and meta-analysis.
abstract: BACKGROUND
  Many patients presenting for general medical care have a history of sexual abuse. The literature suggests an association between a history of sexual abuse and somatic sequelae.
  
  
  OBJECTIVE
  To systematically assess the association between sexual abuse and a lifetime diagnosis of somatic disorders. Data Sources and Extraction A systematic literature search of electronic databases from January 1980 to December 2008. Pairs of reviewers extracted descriptive, quality, and outcome data from included studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled across studies by using the random-effects model. The I(2) statistic was used to assess heterogeneity.
  
  
  METHODS
  Eligible studies were longitudinal (case-control and cohort) and reported somatic outcomes in persons with and without history of sexual abuse.
  
  
  RESULTS
  The search identified 23 eligible studies describing 4640 subjects. There was a significant association between a history of sexual abuse and lifetime diagnosis of functional gastrointestinal disorders (OR, 2.43; 95% CI, 1.36-4.31; I(2) = 82%; 5 studies), nonspecific chronic pain (OR, 2.20; 95% CI, 1.54-3.15; 1 study), psychogenic seizures (OR, 2.96; 95% CI, 1.12-4.69, I(2) = 0%; 3 studies), and chronic pelvic pain (OR, 2.73; 95% CI, 1.73-4.30, I(2) = 40%; 10 studies). There was no statistically significant association between sexual abuse and a lifetime diagnosis of fibromyalgia (OR, 1.61; 95% CI, 0.85-3.07, I(2) = 0%; 4 studies), obesity (OR, 1.47; 95% CI, 0.88-2.46; I(2) = 71%; 2 studies), or headache (OR, 1.49; 95% CI, 0.96-2.31; 1 study). We found no studies that assessed syncope. When analysis was restricted to studies in which sexual abuse was defined as rape, significant associations were observed between rape and a lifetime diagnosis of fibromyalgia (OR, 3.35; 95% CI, 1.51-7.46), chronic pelvic pain (OR, 3.27; 95% CI, 1.02-10.53), and functional gastrointestinal disorders (OR, 4.01; 95% CI, 1.88-8.57).
  
  
  CONCLUSIONS
  Evidence suggests a history of sexual abuse is associated with lifetime diagnosis of multiple somatic disorders.
authors: Mayo Clinic College of Medicine, Rochester, MN 55906, USA.
authors: Molly L
authors: ML
authors: Paras
authors: Mohammad Hassan
authors: MH
authors: Murad
authors: Laura P
authors: LP
authors: Chen
authors: Erin N
authors: EN
authors: Goranson
authors: Amelia L
authors: AL
authors: Sattler
authors: Kristina M
authors: KM
authors: Colbenson
authors: Mohamed B
authors: MB
authors: Elamin
authors: Richard J
authors: RJ
authors: Seime
authors: Larry J
authors: LJ
authors: Prokop
authors: Ali
authors: A
authors: Zirakzadeh
mesh_terms: D006801:Humans; D012742:Sex Offenses / Q000523:psychology* / Q000706:statistics & numerical data; D013001:Somatoform Disorders / Q000453:epidemiology / Q000209:etiology*; D017741:Survivors / Q000523:psychology