Official websites use. Share sensitive information only on official, secure websites. Address correspondence and requests for reprints to Dr. While the association between abuse in childhood and adverse adult health outcomes is well established, this link is infrequently acknowledged in the general medical literature.
This paper has 2 purposes: 1 to provide a broad overview of the research on the long-term effects of child abuse on mental and physical health including some of the potential pathways, and 2 to call for collaborative action among clinicians, psychosocial and biomedical researchers, social service agencies, criminal justice systems, insurance companies, and public policy makers to take a comprehensive approach to both preventing and dealing with the sequelae of childhood abuse.
Keywords: anxiety, depression, hostility, medical diagnoses, childhood abuse, somatic symptoms. The association between childhood abuse and adverse adult health outcomes is well established. The need for more visible research that will reach physicians who provide the bulk of front line health care is underscored by failure to give even passing mention to the well-documented link between adult depression and childhood abuse in a recent review on depression in the New England Journal of Medicine.
Similar omissions occur in recent reviews of fibromyalgia, 25 anorexia nervosa, 26 and functional somatic syndromes 27 , 28 in prestigious, high-impact medical journals. Irritable bowel is the single exception, where through the work of Drossman and Leserman, 7 , 29 the association of this disorder with a history of childhood or adult sexual and physical abuse in women is now consistently mentioned in reviews of functional bowel disorders.
If physicians caring for adults who suffer from a condition associated with abuse in childhood are unaware of this link, they will neither elicit an abuse history nor make appropriate patient referrals. Furthermore, while most patients say they want their physicians to screen for a history of abuse, most physicians admit that they do not do so.
