Incidence ~5%/yr, 20-33% of women have a pos hx (Jama 1998;280:433; Ann IM 1995;123:737). Highest risk in women whose male partners abuse drugs or alcohol, are unemployed, and have less than a high school education
Sx:Trauma; functional gi disorders (Ann IM 1995;123:782), anxiety, depression, somatization
Si:Trauma in excess of hx + above
Rx:
Screen by asking, "Have you been hit, kicked, punched, or otherwise injured in this past year, and if so by whom?"; 70% sens, 85% specif (Jama 1997;277:1357), but do it sensitively (Ann IM 1999;131:578) and USPSTF rates data indeterminant (Ann IM 2004;140:382, 387, vs 399)
Advocate for, offer choices, avoid blaming, assess danger; national hotline: 1-800-799-SAFE