title: Evaluating exposure to abuse and violence in neurological patients.
abstract: OBJECTIVE
  The relationship between abuse and violence and the care of neurological patients is an important topic not often addressed, and studies suggest that most neurologists do not routinely screen patients for abuse. In this pilot study, our aim was to demonstrate a simple and effective strategy for screening patients for exposure to abuse.
  
  
  METHODS
  A total of 103 consecutive patients reporting to an academic neurology clinic specializing in autonomic and movement disorders were screened for a history of abuse and violence. A set of 6 questions were included in the standard patient intake questionnaire. The questions were then repeated verbally during the physician history taking. All patients were provided with information on available local resources for abuse counseling during the visit. Retrospective chart review analysis was performed to determine the prevalence of history of abuse in the population, the most common type of abuse suffered, and the number of individuals reporting current abuse.
  
  
  RESULTS
  Twenty-two of the 103 patients (21%) screened for abuse reported exposure to abuse or violence. Two patients with ongoing issues with abuse were identified. The most commonly reported abuse was being a witness to violence (65%), followed by physical abuse (41%), sexual and emotional abuse (36% each), and financial abuse (23%). The neurological disorders most frequently observed in these patients were chronic pain, neuropathy, autonomic dysfunction, headache, and Parkinson disease.
  
  
  CONCLUSIONS
  Patients with neurological disorders may have been exposed to abuse and violence. It is important to recognize these issues and address them routinely in the neurological evaluation. A simple, effective way to accomplish screening in the outpatient setting is through the use of an intake questionnaire combined with verbal clarification.
authors.affiliation: Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Roque
authors.forename: Janice
authors.initials: J
authors.lastname: Weinberg
authors.forename: Anna Depold
authors.initials: AD
authors.lastname: Hohler
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology / Q000523:psychology*; D010865:Pilot Projects; D012189:Retrospective Studies; D012742:Sex Offenses / Q000523:psychology; D013179:Spouse Abuse / Q000523:psychology; D011795:Surveys and Questionnaires; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data