Do physical and sexual abuse differentially affect chronic pain states in women?

To evaluate the role of physical and/or sexual abuse on chronic pain sympto ms and health care utilization in women, 104 consecutive female patients pr esenting to a multidisciplinary pain center for management of chronic pain were surveyed. Outcomes included a measure of sexual or physical abuse hist ory (Drossman Sexual-Physical Abuse Survey), and measures of anxiety, healt h care utilization, substance abuse, and somatic symptoms. Forty-eight perc ent of the sample reported a history of physical abuse (PA) or sexual al ab use (SA). Forty percent of the abused patients reported both PA and SA and the remainder reported SA (37%) or PA (23%) alone. The women who reported a buse had increased pain, physical symptoms, anxiety symptoms, and mental he alth care utilization compared to nonabused women. The women who reported a buse were also more likely to smoke and abuse street drugs. Women who repor ted both PA and SA were more likely to report heart pain when compared to t hose who reported only PA or SA. Given the impact of abuse, particularly SA , on the presentation of chronic pain, queries regarding abuse should becom e a routine component of the patient interview. Abused patients should be r eferred to mental health care practitioners as a component of successful pa in management if unresolved issues persist. (C) U.S. Cancer Pain! Relief Co mmittee, 1999.