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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Family planning (FP) services were integrated into 13 drug treatment programs in July 1989 in Philadelphia providing services to 1250 women a year on birth control methods, sexually transmitted diseases (STDs), HIV risk assessment, and pregnancy testing. Among 599 female drug treatment clients aged 16-56 baseline interviews were conducted followed up by interviews 9 months and 15 months later. 58% were black, 37% white, and 5% Asian. 58% had a high school education. 14% were married, and 36% were divorced, separated, or widowed. 81% already had 1 child. 25% had injected heroin and 16% cocaine in the previous 4 weeks. 76% of sexually active women had not used condoms. FP clients made 3139 visits in the course of 24 months for counseling and medical purposes. 6 focus groups with 30 men and 35 women aged 16-60 were conducted 12 months after the integration of services. Most were aware about the availability of FP services: 61% of 958 women received STD advice, 67% of 258 women at 4 sites were screened for gonorrhea and 40% for syphilis. 76% of 599 women stated that their last pregnancy had been unintended. Most thought that contraceptives caused weight gain, headache, water retention, mood swings, blood clots, bleeding, or cancer. Among the sample of 599 women 15% had used the condom, 55 had used the pill, 7% had used the sponge, the IUD, or others, 38% had not used any method in the preceding 4 weeks. 42% of 873 of sexually active women receiving FP counseling planned to use the condom. 27% of drug treatment clients had been sterilized. Most women did not use the condom or other contraceptives in order to preserve their relationships. Many had experienced violence, incest, sexual abuse, and rape. In an all-male focus group all had been either victims or committed sexual violence. Both staff and clients liked the integration of drug treatment and FP.
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PMID:Barriers to family planning services among patients in drug treatment programs. 178 7

Major depression disease is uncommon in children; it occurs mostly in children with a depressed parent or in children under major psychosocial stress such as physical or sexual abuse. Most depression in children is masked, i.e., the child presents with signs or symptoms such as headaches, abdominal pain, muscle weakness, vomiting, dizziness, hyperactivity, or school avoidance. Careful evaluation of the history is required to assist in the diagnosis. Some basic laboratory tests should be done to rule out organic disease. Psychiatric referral should be carried out after an appropriate evaluation.
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PMID:Depression and chronic fatigue in children. A masquerade ball. 187 11

A 15-year-old girl with chronic muscle-contraction headache was treated initially using a behaviourally based headache programme. Little change in headache activity resulted. Implosive therapy was incorporated into treatment after the girl revealed a past episode of sexual abuse. A substantial reduction in headache activity was noted at post-treatment and follow-up.
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PMID:Treatment of a 15-year-old girl with chronic muscle-contraction headache using implosive therapy. 188 57

One hundred thirty-one patients who gave a history of childhood sexual abuse were seen in a general medical practice decades after the event and were compared with a control group. The subject patients were found to be distinct for chronic depression, morbid obesity, marital instability, high utilization of medical care, and certain psychosomatic symptoms, particularly chronic gastrointestinal distress and recurrent headaches. It is clear that these remote events can underlie difficult chronic medical problems. Questions about childhood sexual abuse must become part of the practitioner's review of systems in these difficult cases, if not routinely.
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PMID:Long-term medical consequences of incest, rape, and molestation. 160 4

To study the clinical phenomenology of multiple personality, 50 consecutive patients with DSM-III multiple personality disorder were assessed using clinical history, psychiatric interview, neurological examination, electroencephalogram, MMPI, intelligence testing, and a variety of psychiatric rating scales. Results revealed that patients with multiple personality are usually women who present with depression, suicide attempts, repeated amnesic episodes, and a history of childhood trauma, particularly sexual abuse. Also common were headaches, hysterical conversion, and sexual dysfunction. Intellectual level varied from borderline to superior. The MMPI reflected underlying character pathology in addition to depression and dissociation. Significant neurological or electroencephalographical abnormalities were infrequent. These data suggest that the etiology of multiple personality is strongly related to childhood trauma rather than to an underlying electrophysiological dysfunction.
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PMID:Multiple personality disorder. A clinical investigation of 50 cases. 341 21

The long-term impact of child sexual abuse (CSA) has most typically been concentrated on the psychological outcomes. The aim of the present study was to examine the relationship between CSA and self-reported complaints including both psychological and psychosomatic problems as well as absenteeism. A random sample of 510 female and 486 male students completed a questionnaire that included questions about CSA. The overall response rate was 75.3%. A symptom scale was constructed by asking the respondents to rate themselves on a three-category scale for 13 items concerning both psychological and somatic health problems. They were also asked to indicate how many days the problem had caused them to be absent from class or work during the year prior to the study. CSA was reported by 116 of the students (11.7%). CSA was associated with a broad range of health problems; including genital pain/infections and headache/abdominal/muscular pain as well as psychological disorders such as anxiety and suicidal ideations. A linear relationship was demonstrated between the severity of CSA and the symptom score, as well as between the severity of CSA and days absent from work. Postpubertal onset of abuse and close relationship with the offender were positively associated with the number of sick-leave days.
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PMID:The impact of child sexual abuse--a study of a random sample of Norwegian students. 780 91

Psychiatric nurses are confronted daily with individuals who are suffering from the consequences of trauma. Physical and sexual abuse is associated with acute psychiatric symptomatology in children and may progress to a spectrum of psychiatric and medical disorders in adults, ranging from the extreme adaptive reactions seen in multiple personality disorder and refractory psychosis to intermediate adaptive reactions present in borderline personality disorder to more delimited reactions manifest in chronic headaches and unremitting pelvic pain. Subjects sampled in inpatient, outpatient, psychiatric, medical, criminal, and community settings describe the link between histories of widespread abuse and various intractable and common disorders. This article presents the state-of-the-art knowledge of the long-term sequelae of childhood physical and sexual abuse by critically reviewing the initial uncontrolled investigations and mounting evidence from controlled studies.
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PMID:Long-term consequences of childhood physical and sexual abuse. 837 64

Researchers have increasingly demonstrated that 15% to 30% of all women have been sexually abused as children. Information on the emotional, behavioral, and cognitive sequelae of this abuse has been available. Most recently, a literature on the somatic and medical sequelae has developed. This article reviews this literature and discusses its implications for primary care providers. Survivors are likely to suffer from insomnia, gastrointestinal problems, obesity, chronic pain, headache, and somatization, and they are frequent utilizers of primary care services. Specific suggestions about history taking, physical examination, and referrals are given to ensure that survivors receive care that is sensitive, supportive, and competent. The article also discusses the dynamics of abuse and how they relate to the ongoing relationship between the primary care provider and the survivor of sexual abuse.
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PMID:The sequelae of childhood sexual abuse: a primary care focus for adult female survivors. 923 50

To evaluate the role of physical and/or sexual abuse on chronic pain symptoms and health care utilization in women, 104 consecutive female patients presenting to a multidisciplinary pain center for management of chronic pain were surveyed. Outcomes included a measure of sexual or physical abuse history (Drossman Sexual-Physical Abuse Survey), and measures of anxiety, health care utilization, substance abuse, and somatic symptoms. Forty-eight percent of the sample reported a history of physical abuse (PA) or sexual abuse (SA). Forty percent of the abused patients reported both PA and SA and the remainder reported SA (37%) or PA (23%) alone. The women who reported abuse had increased pain, physical symptoms, anxiety symptoms, and mental health care utilization compared to nonabused women. The women who reported abuse were also more likely to smoke and abuse street drugs. Women who reported both PA and SA were more likely to report head pain when compared to those who reported only PA or SA. Given the impact of abuse, particularly SA, on the presentation of chronic pain, queries regarding abuse should become a routine component of the patient interview. Abused patients should be referred to mental health care practitioners as a component of successful pain management if unresolved issues persist.
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PMID:Do physical and sexual abuse differentially affect chronic pain states in women? 1064 68

High medical utilization in adults has been linked to both reported history of childhood abuse and mental health problems. However, few studies have explored relationships between abuse severity and psychological distress to identify subgroups with unique utilization patterns and medical complaints. This study compared two groups of psychologically distressed, high utilizers. One group (DS) was comprised of those with psychological distress, who reported a history of child sexual abuse (CSA); the other group (DSP) consisted of those with psychological distress, who reported CSA plus a history of childhood physical abuse. The groups were compared on severity of sexual and nonsexual child maltreatment, medical complaints and medical utilization. From a convenience sample of 206 females age 20-63, recruited while waiting for a physician appointment in a primary care clinic, we compared 25 DSPs to 33 DSs. Compared with DSs, DSPs reported significantly more severe: (1) sexual abuse including completed intercourse; (2) emotional abuse; (3) emotional neglect; and (4) psychological distress. DSPs also showed a nonsignificant trend towards more severe physical neglect. In addition to being significantly higher on emergency room visits, DSPs were marginally higher than DSs on nonpsychiatric outpatient visits. DSPs had significantly more frequent chronic and acute pain complaints at emergency room (ER) visits. Headaches were the most frequently coded diagnosis at ER visits in this sample. DSPs accounted for 89% of these ER visits attributable to headaches. The interaction of psychological distress and reported severity of child maltreatment reveals subgroups with unique utilization patterns and medical complaints. Physicians should screen patients for child maltreatment severity and psychological distress and should be involved in mental health referral where necessary.
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PMID:Severity of child maltreatment, pain complaints and medical utilization among women. 1116 9


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