Am J Psychiatry 1993; 150:1502-1506
Copyright © 1993 by American Psychiatric Association
Histories of sexual victimization in patients with irritable bowel syndrome or inflammatory bowel disease
EA Walker, WJ Katon, PP Roy-Byrne, RP Jemelka and J Russo
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195.
OBJECTIVE: Two reports have suggested a possible association between a
history of sexual trauma and irritable bowel syndrome, but several factors
in their study designs limited their generalizability. The authors used a
more rigorous methodology to confirm this association. METHOD: They
administered structured psychiatric and sexual trauma interviews to 28
patients with irritable bowel syndrome and 19 patients with inflammatory
bowel disease and compared prevalence rates of sexual victimization in the
two groups. RESULTS: Compared with patients diagnosed as having
inflammatory bowel disease, patients with irritable bowel syndrome had a
significantly higher rate of severe lifetime sexual trauma (32% versus 0%),
severe childhood sexual abuse (11% versus 0%), and any lifetime sexual
victimization (54% versus 5%). The nine patients who had experienced severe
lifetime victimization had significantly higher odds ratios for lifetime
depression, panic disorder, phobia, somatization disorder, alcohol abuse,
functional dyspareunia, and inhibited sexual desire than the 38 patients
who had experienced less severe sexual trauma or no trauma. A logistic
regression analysis showed that gender, the number of medically unexplained
physical symptoms, and self-reported anxiety and hostility accounted for
all of the variance in the victimized group. CONCLUSIONS: These preliminary
results suggest that sexual victimization may be an important factor in the
development of irritable bowel syndrome in some patients. Future studies
attempting to categorize subgroups of patients with irritable bowel
syndrome should inquire into past histories of sexual victimization.
