Sexual Abuse and a Lifetime Diagnosis of Somatic Disorders
Ali Zirakzadeh, MD
Department of General Internal Medicine
Mayo Clinic
Rochester, Minnesota
Sexual abuse is commonly encountered in the histories of patients seeking medical care. Strong evidence supports an association between a history of sexual abuse and various psychiatric disorders. Evidence linking sexual abuse and development of somatic disorders is surprising limited, however. In a systematic review of the available evidence, Paras et al identified associations between sexual abuse and a lifetime diagnosis of nonspecific chronic pain, functional gastrointestinal disorders, psychogenic seizures, and chronic pelvic pain. Restricting the definition of sexual abuse to rape further revealed significant associations with a lifetime diagnosis of fibromyalgia, chronic pelvic pain, and functional gastrointestinal disorders. Future studies should aim to clarify these associations and associated genotypes; elucidate potential roles of neuroendocrine and hypothalamic-pituitary axis dysregulation; and improve clinical outcomes potentially by targeting precipitating events and underlying pathophysiologic mechanisms.
Sexual Abuse and a Lifetime Diagnosis of Somatic Disorders
Ali Zirakzadeh, MD
Department of General Internal Medicine
Mayo Clinic
Rochester, Minnesota
Sexual abuse is commonly encountered in the histories of patients seeking medical care. Strong evidence supports an association between a history of sexual abuse and various psychiatric disorders. Evidence linking sexual abuse and development of somatic disorders is surprising limited, however. In a systematic review of the available evidence, Paras et al identified associations between sexual abuse and a lifetime diagnosis of nonspecific chronic pain, functional gastrointestinal disorders, psychogenic seizures, and chronic pelvic pain. Restricting the definition of sexual abuse to rape further revealed significant associations with a lifetime diagnosis of fibromyalgia, chronic pelvic pain, and functional gastrointestinal disorders. Future studies should aim to clarify these associations and associated genotypes; elucidate potential roles of neuroendocrine and hypothalamic-pituitary axis dysregulation; and improve clinical outcomes potentially by targeting precipitating events and underlying pathophysiologic mechanisms.
References