Individuals who experienced a sexual assault are at higher risk of developing functional somatic disorder (FSD)—widespread issues with fatigue, discomfort, and pain sensitivity—over the subsequent five years, according to a study published yesterday in JAMA Psychiatry.Take-home message: “The results suggest that the consequences of [sexual assault] extend across multiple organ systems … rather than confinement to one organ system,” wrote Sofie A. Jacobsen, Ms.P.H., of Aarhus University Hospital in Denmark, and colleagues.
Methods: The researchers made use of data from the Danish Study of Functional Disorders, a large population-based study tracking the development and progression of FSD and related functional somatic syndromes (FSS) like chronic fatigue and irritable bowel syndrome. Their included 4,229 adults (54% female) who had no FSD or FSS at baseline; of this total, 149 adults (91% female) had experienced a sexual assault.
Key results: During a five-year follow-up period:
- 18.8% of adults with exposure to sexual assault developed an FSD, compared with 8.4% of those without.
- 23.5% of adults with exposure to sexual assault developed an FSS, compared with 9.7% of those without.
After adjusting for variables like sex, emotional distress levels, neuroticism levels, and medical comorbidities, Jacobson and colleagues found that individuals exposed to sexual assault had a 69% increased risk of developing an FSD and a 54% increased risk of developing an FSS.
In examining individual syndromes, the researchers found that somatic repercussions of sexual assault are not equal—sexual assault was associated with chronic widespread pain, for example, but not irritable bowel syndrome or chronic fatigue.
However, individuals who experienced a sexual assault were particularly vulnerable to developing multi-organ FSD, defined as having bothersome symptoms from at least three of four clusters: cardiopulmonary, gastrointestinal, musculoskeletal, and general/fatigue.
Further, the prevalence of somatic symptoms was quite stark among individuals who experienced a sexual assault—even in the absence of a formal diagnosis. For example:
- More than 80% reported excess fatigue.
- More than 70% reported back, joint, or muscle pain.
- More than 60% reported difficulty concentrating or memory impairment.
What it means: “Our results are aligned with broader evidence linking various forms of early life trauma, including [sexual assault], and chronic pain in adulthood,” the researchers wrote.
For related information, see the American Journal of Psychotherapy article “Psychodynamic Psychotherapy for Patients With Functional Somatic Disorders and the Road to Recovery.”
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