MEDICAL AND PSYCHIATRIC-SYMPTOMS IN FEMALE GASTROENTEROLOGY CLINIC PATIENTS WITH HISTORIES OF SEXUAL VICTIMIZATION

Several recent retrospective reports have associated prior sexual vict imization and long-term medical sequelae such as increased medical cli nic utilization and reports of physical symptoms. However, methodologi cal constraints have limited the generalizability of these findings. O ur study was designed using structured interviews with a sequential sa mple of 89 female gastroenterology clinic patients, who were classifie d by severity of sexual trauma and studied for differences in lifetime psychiatric diagnoses, physical abuse, and medically unexplained symp tom patterns. Compared with the 46 women who had experienced less seve re or no prior sexual trauma, the 43 patients with severe victimizatio n had significantly higher lifetime and current rates of several selec ted psychiatric disorders as well as significantly higher mean numbers of lifetime psychiatric disorders, medically unexplained physical and anxiety symptoms, greater harm avoidance and dissociation scores, and increased functional disability. A logistic regression showed that th e main predictors of a history of severe sexual abuse were the number of medically unexplained symptoms, adult physical abuse, and lifetime dysthymic disorder. We concluded that women with prior severe sexual t rauma episodes may express medically unexplained physical symptoms as part of the long-term adaptation to their victimization.