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Abusive experiences and psychiatric morbidity in women primary care attenders

Department of Psychiatry, Barts and the London, Queen Mary’s School of Medicine and Dentistry, University of London

JO RICHARDSON, MRCGP

Department of General Practice and Primary Care, Barts and the London, Queen Mary’s School of Medicine and Dentistry, University of London

STIRLING MOOREY, FRCPsych

Maudsley Hospital, London

GENE FEDER, MD

Department of General Practice and Primary Care, Barts and the London, Queen Mary’s School of Medicine and Dentistry, University of London, London

Correspondence: Professor Jeremy Coid, Forensic Psychiatry Research Unit, St Bartholomew’s Hospital, William Harvey House, 61 Bartholomew Close, London EC1A 7BE, UK. Tel: 020 7601 8138; fax: 020 7601 7969

Declaration of interest None. Funding detailed in Acknowledgements.

See invited commentary, pp. 340–341, this issue.

Background Abusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging.

Aims To measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders.

Method A cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression.

Results Childhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year.

Conclusions Abuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.

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Highlights of this issue

ELIZABETH WALSH
BJP 2003 183: 273-a15. [Full Text]  

Invited commentary on: Abusive experiences and psychiatric morbidity in women primary care attenders

Paul E. Mullen
BJP 2003 183: 340-341. [Full Text]  

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