Leserman J, Drossman D A, Li Z, Toomey T C, Nachman G, Glogau L
Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill 27599-7160, USA.
Psychosom Med. 1996 Jan-Feb;58(1):4-15. doi: 10.1097/00006842-199601000-00002.
There is an increasing amount of literature pointing to a relationship between sexual and/or physical abuse history and poor health status, although few studies provide evidence concerning which aspects of abuse may impact on health. In female patients with gastrointestinal (GI) disorders, the present study examined the effects on health status of: 1) history of sexual abuse and physical abuse, 2) invasiveness or seriousness of sexual abuse and physical abuse, and 3) age at first sexual and physical abuse.
The sample included 239 female patients from a referral gastroenterology clinic who were interviewed to assess sexual and physical abuse history.
We found the following: 1) 66.5% of patients experienced some type of sexual and/or physical abuse; 2) women with sexual abuse history had more pain, non-GI somatic symptoms, bed disability days, lifetime surgeries, psychological distress, and functional disability compared to those without sexual abuse; 3) women with physical abuse also had worse health outcome on most health status indicators; 4) rape (intercourse) and life-threatening physical abuse seem to have worse health effects than less serious physical violence, and sexual abuse involving attempts and touch; and 5) those with first abuse in childhood did not appear to differ on health from those whose first abuse was as adults.
The authors conclude that asking about abuse should be integrated into history taking within referral-based gastroenterology practices.
越来越多的文献指出性虐待和/或身体虐待史与健康状况不佳之间存在关联，尽管很少有研究提供有关虐待的哪些方面可能影响健康的证据。在患有胃肠道（GI）疾病的女性患者中，本研究考察了以下因素对健康状况的影响：1）性虐待和身体虐待史；2）性虐待和身体虐待的侵入性或严重性；3）首次遭受性虐待和身体虐待的年龄。
样本包括来自一家转诊胃肠病诊所的239名女性患者，对她们进行访谈以评估性虐待和身体虐待史。
我们发现以下情况：1）66.5%的患者经历过某种类型的性虐待和/或身体虐待；2）有性虐待史的女性与没有性虐待史的女性相比，有更多的疼痛、非胃肠道躯体症状、卧床残疾天数、终生手术次数、心理困扰和功能残疾；3）有身体虐待史的女性在大多数健康状况指标上的健康结果也更差；4）强奸（性交）和危及生命的身体虐待似乎比不太严重的身体暴力以及涉及未遂和触摸的性虐待对健康的影响更糟；5）童年时期首次遭受虐待的人与成年后首次遭受虐待的人在健康方面似乎没有差异。
作者得出结论，在基于转诊的胃肠病诊疗实践中，询问虐待情况应纳入病史采集过程中。
