Chronic pain and health care utilization in women with a history of childhood sexual abuse

Objective: This cross-sectional controlled study investigated the association between chronic pain, health care utilization and a history of childhood sexual abuse. Subjects: Three groups, constituting 80 women in total, were studied (1) attendees at group therapy for individuals who had experienced childhood sexual abuse (n = 26); (2) Two control groups consisting of nonabused (a) psychiatric outpatients (n = 33); and (b) nurses (n = 21). Setting: The setting was a university affiliated community and tertiary care hospital in London, Ontario. Outcome Measures: Each subject voluntarily completed questionnaires documenting history of childhood abuse, pain, psychological symptomatology and medical and surgical history. Results: Sixty-nine percent of the women who had experienced childhood sexual abuse reported a chronic painful condition lasting more than three months, compared to 43% of the combined control groups (p = .026). Women who had experienced childhood sexual abuse reported a greater number of painful body areas (p = .003), more diffuse pain and more diagnoses of fibromyalgia (p = .013). They had more surgeries (p = .037), hospitalizations (p = .0004) and family physician visits (p = .046). Conclusions: Women with a history of childhood sexual abuse reported more chronic pain symptoms and utilized more health care resources compared to nonabused control subjects, identification of such a history in the patient experiencing persisting pain may be the first step toward a successful combination of medical and psychosocial interventions. (C) 2000 Elsevier Science Ltd.