NEW YORK (Reuters Health) - Even if the obvious signs of domestic violence can be hidden, women who are abused may be at risk of other conditions not usually associated with such abuse, according to a new study.
Women who have been abused by their partners in the past year are more likely than women who have never been abused to be diagnosed with illnesses ranging from depression to chest pain to urinary tract infections, a new study in the Archives of Internal Medicine shows.
"They had elevated risks of about half of the diagnoses we examined in our study," Dr. Amy E. Bonomi of Ohio State University in Columbus, the study's lead author, told Reuters Health. Based on the findings, she added, doctors whose patients come to see them for these complaints should ask whether they are experiencing domestic violence.
Several studies have linked abuse to illness, but much of this research has looked at women who are being severely abused---for example, those seeking emergency care after being harmed by their partner or those who have filed orders of protection against their partners, Bonomi and her team note in the Archives of Internal Medicine.
To get a better sense of the relationship in the general population of women, Bonomi and her colleagues surveyed 3,568 randomly chosen female members of Group Health Cooperative, a health plan covering Washington State and Idaho. Eight percent of the women had experienced some type of domestic violence in the previous year, while 37 percent reported having suffered domestic abuse in their lifetime.
The researchers compared the 1,686 women who had never been abused to the 242 who reported recent domestic violence, going through their medical records to find out whether they had been diagnosed with any of 29 different conditions over the last year.
The women who reported violence were nearly six times as likely to have been diagnosed with substance use disorders, the researchers found, while they were at nearly five-fold greater risk of "family and social problems." Their risk of depression was more than tripled, while anxiety diagnoses were nearly three times as common among these women.
Other diagnoses that were more common among recently abused women included low back and neck pain; sprains and strains; sexually transmitted diseases; lacerations, bruises and scrapes; urinary tract infections; chest pain; and gastroesophageal reflux disease.
The women with a recent history of abuse were also about twice as likely to use tobacco.
The findings probably underestimate the relationship between abuse and ill health, Bonomi and her team note, because women who suffer domestic violence are less likely to have health insurance-and all of the women in the current study had belonged to the health plan for at least three years.
"In most of these cases abuse probably never entered into the conversation, nor does the physician necessarily ask about it," Bonomi said in an interview. "We would suggest a targeted screening approach for women with elevated rates of certain diagnoses."
If a woman does report being in an abusive relationship, Bonomi added, her doctor can link her up with support services, ideally through an advocate who can help the woman find the legal, medical and social help she needs. While most communities aim to have such services in place, the researcher said, budget woes have led to major cuts, especially in rural areas.
SOURCE: Archives of Internal Medicine, October 12, 2009.
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