Health-related quality of life and symptom profiles of female survivors of sexual abuse

• Published in: Archives of family medicine 1999-01, Vol.8 (1), p.35-43
• Main Authors: Dickinson, L M, deGruy, 3rd, F V, Dickinson, W P, Candib, L M
• Format: Magazinearticle
• Language: English
• Subjects: Child; Child Abuse, Sexual - psychology; Child, Preschool; Female; Health Status; Humans; Linear Models; Prevalence; Quality of Life; Severity of Illness Index; Sex Offenses - psychology; Sex Offenses - statistics & numerical data; Surveys and Questionnaires; United States; Women's Health
• ISSN: 1063-3987; 1941-1758
• DOI: 10.1001/archfami.8.1.35

To determine the association between severity of sexual abuse and psychiatric or medical problems in a sample of female patients from primary care medical settings and to assess the relationship between sexual abuse severity and health-related quality of life before and after controlling for the effects of a current psychiatric or medical diagnosis. Structured interview and self-report questionnaire. Three family practice outpatient clinics. A total of 252 women selected by somatization status using a screen for unexplained physical symptoms. Patient assessment after administering the Medical Outcomes Study 36-item Short-Form Health Survey and self-report medical problems questionnaire; the quality-of-life scale developed by Andrews and Withey; Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, diagnoses and symptom counts from the Diagnostic Interview Schedule; the Dissociative Experiences Scale; and the modified Dissociative Disorders Interview Schedule. A history of sexual abuse is associated with substantial impairment in health-related quality of life and a greater number of somatized symptoms (P < .001), medical problems (P < .01), and psychiatric symptoms and diagnoses (P < .001). In regression analyses, sexual abuse severity was a significant predictor of high scores on 6 of the 8 subscales of the Medical Outcomes Study Short-Form Health Survey (P < .05) and all of the quality-of-life subscales developed by Andrews and Withey (P < .01), with average decrements of up to 0.41 SDs for moderately abused women and 0.56 SDs for severely abused women. Furthermore, sexual abuse severity remained a significant predictor of high scores on the subscales mental health (P < .05), social functioning (P < .05), and quality of life (P < .05), even after adjusting for the presence of several common psychiatric diagnoses. Female primary care patients with a history of sexual abuse have more physical and psychiatric symptoms and lower health-related quality of life than those without previous abuse. In addition, a linear relationship exists between the severity of sexual abuse and impairment in health-related quality of life, both before and after controlling for the effects of a current psychiatric diagnosis.