Abstract
Domestic abuse is a global public health issue. The association between the development of central sensitivity syndromes (CSS) and previous exposure to domestic abuse has been poorly understood particularly within European populations. A retrospective cohort study using the 'The Health Improvement Network,' (UK primary care medical records) between 1st January 1995-31st December 2018. 22,604 adult women exposed to domestic abuse were age matched to 44,671 unexposed women. The average age at cohort entry was 36years and the median follow-up was 2.5years. The outcomes of interest were the development of a variety of syndromes which demonstrate central nervous system sensitization. Fibromyalgia, chronic fatigue syndrome and temporomandibular joint disorder outcomes have been reported previously. Outcomes were adjusted for the presence of mental ill health. During the study period, women exposed to domestic abuse experienced an increased risk of developing chronic lower back pain (adjusted incidence rate ratio [aIRR] 2.28; 95% CI 1.85-2.80), chronic headaches (aIRR 3.15; 95% CI 1.07-9.23), irritable bowel syndrome (aIRR 1.41; 95% CI 1.25-1.60) and restless legs syndrome (aIRR 1.89; 95% CI 1.44-2.48). However, no positive association was seen with the development of interstitial cystitis (aIRR 0.52; 95% CI 0.14-1.93), vulvodynia (aIRR 0.42; 95% CI 0.14-1.25) and myofascial pain syndrome (aIRR 1.01; 95% CI 0.28-3.61). This study demonstrates the need to consider a past history of domestic abuse in patients presenting with CSS; and also consider preventative approaches in mitigating the risk of developing CSS following exposure to domestic abuse. Domestic abuse is a global public health issue, with a poorly understood relationship with the development of complex pain syndromes. Using a large UK primary care database, we were able to conduct the first global cohort study to explore this further. We found a strong pain morbidity burden associated with domestic abuse, suggesting the need for urgent public health intervention to not only prevent domestic abuse but also the associated negative pain consequences.
Highlights
Domestic abuse (‘controlling, coercive, threatening behaviour, violence or abuse between those >16 who are, or have been, intimate partners or family members’) (HM Government, 2016) is a global public health problem thought to affect up to one in three women (World Health Organization, 2018)
During our study period we identified that exposure to domestic abuse was associated with the development of chronic lower back pain, chronic headaches, irritable bowel syndrome and restless legs syndrome
There was no statistically significant association noted with the development of interstitial cystitis, vulvodynia and myofascial pain syndrome
Summary
Domestic abuse (‘controlling, coercive, threatening behaviour, violence or abuse between those >16 who are, or have been, intimate partners or family members’) (HM Government, 2016) is a global public health problem thought to affect up to one in three women (World Health Organization, 2018). The accepted umbrella term for these conditions is central sensitivity syndromes, and they include fibromyalgia; chronic fatigue syndrome; temporomandibular joint disorders; chronic lower back pain; interstitial cystitis; vulvodynia; chronic headaches; myofascial pain syndrome; irritable bowel syndrome and restless legs syndrome (Moshiree et al, 2006; Nijs et al, 2011). We have conducted the first retrospective cohort study using ‘The Health Improvement Network’ (THIN) dataset to explore the association of domestic abuse exposure in women with the subsequent development of chronic lower back pain, interstitial cystitis, vulvodynia, chronic headaches, myofascial pain syndrome, irritable bowel syndrome and restless legs syndrome
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
