Although there is increasing awareness of the short-term
psychological and social adaptations to childhood sexual abuse, little
is known about the long-term effects of such abuse, particularly its
effect on subsequent medical utilization and the experience and
reporting of physical symptoms. We re-analyzed data from a previous
study of 100 women scheduled for diagnostic laparoscopy (50 for
chronic pain, 50 for tubal ligation or infertility evaluation) who
received structured, physician-administered psychiatric and sexual
abuse interviews. Women were regrouped by severity of childhood sexual
abuse, and we compared the groups with respect to lifetime psychiatric
diagnoses and medically unexplained symptom patterns. Unadjusted odds
ratios showed that risk for lifetime diagnoses of major depression,
panic disorder, phobia, somatization disorder and drug abuse, and
current diagnoses of major depression and somatoform pain disorder
were significantly higher in the severely abused group compared with
women with no abuse or less severe abuse. Logistic regression analysis
demonstrated that number of somatization symptoms, lifetime panic
disorder and drug dependence were predictive of a prior history of
severe childhood sexual abuse. Psychiatric disorders and medical
symptoms, particularly chronic pelvic pain, are common in women with
histories of severe childhood sexual abuse. Clinicians should inquire
about childhood sexual and physical abuse experiences in patients with
multiple medical and psychiatric symptoms, particularly patients with
chronic pelvic pain.