Indicators of woman abuse based on a chart review at a family practice center

To identify demographic and health indicators of domestic violence.

Anonymous questionnaire survey of patients regarding violence and a chart review regarding symptoms and diagnoses.

Community-based family practice residency training center in a midwestern city.

Women 18 years of age or older visiting the center over a 2-month period in 1990. Of 476 eligible participants, 394 (82.7%) consented to complete the survey.

A detailed, standardized measure of violence was used. Physical and psychological problems were given codes from the International Classification of Diseases, Ninth Revision (ICD-9).

Younger women and those separated or divorced from their partners were more likely to have been victims. Never-married women also had substantially high rates of victimization. Depression was the strongest indicator of victimization, even when controlling for demographic factors. Back pain, ulcers, headaches, and anxiety were not strong indicators of abuse. A classification analysis showed that a combination of all variables could predict lifetime injury only about half the time and violence in the past year only about 20% of the time.

Since neither demographic nor health factors could accurately predict who had been victimized, all women need to be asked about abuse. Physicians should also keep in mind that divorced and unmarried women are often affected by abuse, either immediately or by its long-term aftereffects.