Background: There have been many studies docu-menting adverse psychiatric consequences for people who have experienced childhood and adult sexual and physical abuse. These include posttraumatic stress dis-order, anxiety, depression, substance abuse, eating dis-orders and probably some personality disorders or trait abnormalities. Much less is known about the links be-tween abuse and physical/psychosomatic conditions in adult life. Hints of causal links are evident in the literature discussing headache, lower back pain, pelvic pain and irritable bowel syndrome. These studies are not defini-tive as they use clinic-based samples. Methods: This study used interview data with a random community sample of New Zealand women, half of whom reported childhood sexual abuse and half who did not. Details about childhood physical abuse and adult abuse were also collected in a two-phase study. Results: Complex relationships were found, as abuses tended to co-occur. Seven of 18 potentially relevant medical conditions emerged as significantly increased in women with one or more types of abuse. These were chronic fatigue, blad-der problems, headache including migraine, asthma, diabetes and heart problems. Several of these associa-tions with abuse are previously unreported. Conclu-sions: In this random community sample, a number of chronic physical conditions were found more often in women who reported different types of sexual and phys-ical abuse, both in childhood and in adult life. The causal relationships cannot be studied in a cross-sectional ret-rospective design, but immature coping strategies and increased rates of dissociation appeared important only in chronic fatigue and headache, suggesting that these are not part of the causal pathway between abuse experi-ences and the other later physical health problems. This finding and the low co-occurrence of the identified physi-cal conditions suggest relative specificity rather than a general vulnerability to psychosomatic conditions in women who have suffered abuses. Each condition may require separate further study.
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