Childhood Sexual Abuse is Associated With Physical Illness Burden and Functioning in Psychiatric Pat.pdf

Childhood Sexual Abuse is Associated With Physical Illness Burden and Functioning in Psychiatric Patients 50 Years of Age and Older Nancy L. Talbot, PhD, Ben Chapman, PhD, Yeates Conwell, MD, Kelly McCollumn, BA, Nathan Franus, MS, Stefan Cotescu, MD, and Paul R. Duberstein, PhD Department of Psychiatry and the Rochester Center for Mind-Body Research (N.L.T., B.C., N.F., S.C., P.R.D.), University of Rochester School of Medicine and Dentistry, Rochester, New York; Department of Psychiatry and the Center for the Study and Prevention of Suicide (Y.C., P.R.D.), University of Rochester School of Medicine and Dentistry, Rochester, New York; and Child Study Center (K.M.), Yale University, New Haven, Connecticut Abstract Objective—To examine the association of childhood sexual abuse (CSA) with cumulative illness burden, physical function, and bodily pain (BP) in a sample of male and female psychiatric patients ≥50 years of age. Previous research on the health consequences of sexual abuse has focused on nonpsychiatric samples of younger-age adults, especially women. The health implications of abuse for mixed-gender samples of older psychiatric patients have not been explored. Methods—Participants were 163 patients with primary mood disorders. Sexual abuse histories were collected via patient self-report, as was BP. The measure of medical illness burden was based on chart review. Clinical interviewers rated physical function, using the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) scales. Linear and logistic regressions examined the association between CSA and health outcomes. Results—As hypothesized, severe childhood sexual abuse was associated with higher cumulative medical illness burden, worse physical function, and greater BP. Comparisons of regression coefficients revealed that severe CSA’s influence on illness burden is roughly comparable to the effects of adding 8 years of age. For ADL impairment and BP, the effects are comparab