Health-related quality of life and symptom profiles of female survivors of sexual abuse

Arch Fam Med. 1999 Jan-Feb;8(1):35-43. doi: 10.1001/archfami.8.1.35.


Objectives: To determine the association between severity of sexual abuse and psychiatric or medical problems in a sample of female patients from primary care medical settings and to assess the relationship between sexual abuse severity and health-related quality of life before and after controlling for the effects of a current psychiatric or medical diagnosis.

Design: Structured interview and self-report questionnaire.

Setting: Three family practice outpatient clinics.

Subjects: A total of 252 women selected by somatization status using a screen for unexplained physical symptoms.

Main outcome measures: Patient assessment after administering the Medical Outcomes Study 36-item Short-Form Health Survey and self-report medical problems questionnaire; the quality-of-life scale developed by Andrews and Withey; Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, diagnoses and symptom counts from the Diagnostic Interview Schedule; the Dissociative Experiences Scale; and the modified Dissociative Disorders Interview Schedule.

Results: A history of sexual abuse is associated with substantial impairment in health-related quality of life and a greater number of somatized symptoms (P < .001), medical problems (P < .01), and psychiatric symptoms and diagnoses (P < .001). In regression analyses, sexual abuse severity was a significant predictor of high scores on 6 of the 8 subscales of the Medical Outcomes Study Short-Form Health Survey (P < .05) and all of the quality-of-life subscales developed by Andrews and Withey (P < .01), with average decrements of up to 0.41 SDs for moderately abused women and 0.56 SDs for severely abused women. Furthermore, sexual abuse severity remained a significant predictor of high scores on the subscales mental health (P < .05), social functioning (P < .05), and quality of life (P < .05), even after adjusting for the presence of several common psychiatric diagnoses.

Conclusions: Female primary care patients with a history of sexual abuse have more physical and psychiatric symptoms and lower health-related quality of life than those without previous abuse. In addition, a linear relationship exists between the severity of sexual abuse and impairment in health-related quality of life, both before and after controlling for the effects of a current psychiatric diagnosis.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child
  • Child Abuse, Sexual / psychology
  • Child, Preschool
  • Female
  • Health Status*
  • Humans
  • Linear Models
  • Prevalence
  • Quality of Life*
  • Severity of Illness Index
  • Sex Offenses / psychology*
  • Sex Offenses / statistics & numerical data
  • Surveys and Questionnaires
  • United States
  • Women's Health*