Researchers Find Correlation Between Abuse and Chronic Mental Health, Physical Problems in Women

08/04/04    Portland, Ore.


Women who have experienced abuse are at greater risk for long-term mental and physical problems according to a study by Oregon Health & Science University researchers published in the August issue of the Journal of General Internal Medicine. In the study, women who reported any type of personal violence complained of a greater number of chronic physical symptoms than those who were not abused, even though the last episode of violence occurred an average of 14 to 30 years earlier. The risk of suffering from six or more chronic physical symptoms increased with the number of forms of violence experienced.

These findings are important because health care professionals and researchers often only focus on a single form of violence and its symptoms, underestimating the complexity of a woman's health needs. Similarly, the researchers found the presence of multiple physical ailments may be a clue to the fact that the woman has been abused.

"All forms of violence -- physical or sexual child abuse, intimate partner violence and community violence -- are associated with chronic health problems, even decades after the actual assaults occurred. There is great overlap between different forms of violence. People do not fall neatly into categories of 'child abuse survivor' or 'domestic violence survivor' or 'rape survivor.' A majority of the people in this study experienced multiple forms of violence throughout their lifetimes," said Christina Nicolaidis, M.D., M.P.H., principal investigator of the study. She is an assistant professor of medicine (general internal medicine, geriatrics and public health and preventive medicine), OHSU School of Medicine.

"The association between violence and physical symptoms was significant even after adjusting for mental health problems such as depression or post-traumatic stress disorder. The relationship between violence and physical symptoms is not fully explained by, or attributable to, mental health," Nicolaidis said.

The objective of the study was to assess how physical and sexual intimate partner violence, child abuse and community violence relate to long-term mental and physical problems. In addition, the study examined the overlap between different forms of violence and the impact of experiencing multiple forms of violence. Nicolaidis, with fellow researchers MaryAnn Curry, R.N., D.N.Sc., professor emeritus, OHSU School of Nursing; Bentson McFarland, M.D., Ph.D., professor of psychiatry, OHSU School of Medicine; and Martha Gerrity, M.D., Ph.D., associate professor of medicine (general internal medicine and geriatrics), OHSU School of Medicine, interviewed 174 women aged 25 to 60. The majority of women had experienced more than one form of violence. Each form of violence was associated with depressive symptoms and at least six chronic physical symptoms. They concluded multiple types of victimization may contribute to patients' current mental health and physical problems.

The 16 abuse-related chronic ailments studied include: irritable bowel syndrome, fatigue, pelvic pain, widespread muscle pain, headaches, bloating, abdominal pain, back pain, jaw pain, rectal pain, chest pain, diarrhea, constipation, dizziness, fainting spells, palpitations and sensitivity to chemicals.

Nicolaidis said that when clinicians see a patient with depressive symptoms or multiple physical complaints, they should consider the possibility that a lifetime of violence may be negatively affecting a woman's overall health. She advocates more study to understand the relationship between violence and health, and testing effective interventions to prevent further violence in a woman's life.

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