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童年期性虐待及抑郁与躯体症状和医疗利用之间的关系。

The relationship of childhood sexual abuse and depression with somatic symptoms and medical utilization.

作者信息

Newman M G, Clayton L, Zuellig A, Cashman L, Arnow B, Dea R, Taylor C B

机构信息

Department of Psychology, Pennsylvania State University, University Park 16802-3103, USA.

出版信息

Psychol Med. 2000 Sep;30(5):1063-77. doi: 10.1017/s003329179900272x.

Abstract

BACKGROUND

Previous research suggests that childhood sexual abuse is associated with high rates of retrospectively reported medical utilization and medical problems as an adult. The goal of this study was to determine if abused females have higher rates of medical utilization using self-report and objective measures, compared with non-abused females. A further goal was to determine whether findings of prior research would be replicated when childhood physical abuse level was controlled. This study also examined the moderating impact of depressed mood on current health measures in this population.

METHODS

Six hundred and eight women recruited from a health maintenance organization completed self-report measures of health symptoms for the previous month and doctor visits for the previous year. Objective doctor records over a 2 year period were examined for a subset of 136 of these women.

RESULTS

Results showed significantly more self-reported health symptoms and more self-reported doctor visits in abused participants compared with those who reported no childhood history of sexual abuse. Objective doctor visits demonstrated the same pattern with abused participants exhibiting more visits related to out-patient surgery and out-patient internal medicine. In addition, persons who were both sexually abused and depressed tended to visit the emergency room more frequently and to have more in-patient internal medicine and ophthalmology visits than sexually abused participants who reported low depressed mood and non-abused controls.

CONCLUSIONS

These results replicate prior studies and suggest that current depression may moderate the relationship between sexual abuse and medical problems in adulthood.

摘要

背景

先前的研究表明,童年期遭受性虐待与成年后较高的回顾性报告的医疗利用率和医疗问题发生率相关。本研究的目的是确定与未受虐待的女性相比,受虐待的女性通过自我报告和客观测量方法是否具有更高的医疗利用率。另一个目的是确定在控制童年期身体虐待程度时,先前研究的结果是否会得到重复验证。本研究还考察了抑郁情绪对该人群当前健康指标的调节作用。

方法

从一家健康维护组织招募的608名女性完成了上个月健康症状的自我报告测量以及上一年的就诊情况报告。对其中136名女性的子集检查了其两年期间的客观医生记录。

结果

结果显示,与那些报告无童年期性虐待史的女性相比,受虐待参与者自我报告的健康症状显著更多,自我报告的就诊次数也更多。客观医生就诊情况呈现相同模式,受虐待参与者的门诊手术和门诊内科相关就诊次数更多。此外,与报告低抑郁情绪的受性虐待参与者和未受虐待的对照组相比,既遭受性虐待又患有抑郁症的人往往更频繁地前往急诊室就诊,并且有更多的住院内科和眼科就诊次数。

结论

这些结果重复了先前的研究,并表明当前的抑郁症可能会调节成年期性虐待与医疗问题之间的关系。

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