The authors investigated the hypothesis that early abuse might affect the development of the limbic system. During initial psychiatric evaluation, 253 outpatients completed a self-report scale, the Limbic System Checklist-33 (LSCL-33), designed to measure somatic, sensory, behavioral, and memory symptoms suggestive of temporal lobe epilepsy, along with a questionnaire about physical or sexual abuse. Physical abuse was associated with a 38% increase in LSCL-33 scores (P < 0.01), sexual abuse with a 49% increase (P < 0.02), and combined abuse with a 113% increase (P < 0.0001). Physical or sexual abuse alone was associated with elevated LSCL-33 scores only if the abuse occurred before age 18.