Group therapy for women sexually abused as children: mental health before and after group therapy.

Forty-five female outpatients sexually abused in childhood were offered a 2-year phase-divided group therapy. Before and after treatment and at 12 months follow-up, they answered questionnaires designed to elicit responses concerning psychological symptoms (Symptom Checklist; SCL-90) and sense of coherence (SOC). Symptoms for posttraumatic stress disorder (PTSD) were assessed before and after treatment. Inpatient days and sick listing days were assessed during 2 years before and 2 years after treatment. The psychological and PTSD symptoms were significantly reduced after treatment, and the SOC was increased as well. Inpatient days were decreased, and sick listing days increased but not significantly. Compared to a similar short-term focused therapy group and a waiting-list group there were no significant differences between the groups. Trauma-focused group therapy for women who were sexually abused in childhood seems to have promising effects on mental health, both concerning long-term and short-term approaches.

The influence of childhood sexual abuse factors on women's health.

A history of childhood sexual abuse has been shown to be common among adult women, 15-30% in prevalence studies. The childhood sexual abuse variables taken into account are commonly age of onset, duration, abuse forms and relationship between the child and the perpetrator. Within the Department of Psychiatry at Lund University Hospital, 45 women with experiences of childhood sexual abuse were offered a 2-year long trauma-focused group therapy. Half of the women had been sexually abused during childhood in pre-school ages and half by a perpetrator who was the biological father. Two-thirds had been abused for more than 5 years and half through penetration. There was a statistical significance between age of onset (0-6 years) and psychiatric symptoms including eight of nine subscales, according to results from use of the questionnaire Symptom Check List (SCL-90). According to the same questionnaire, there also was a statistical significance between the perpetrator (male relative) and the subscale interpersonal sensitivity. According to the Interview Schedule of Social Interaction, there was a statistical significance between the abuse form penetration and the social integration in the subscale availability of attachment. Thirty-five women (78%) had not told anyone about the sexual abuse when it happened, and the most common reason for this was fear of not being believed.

Childhood sexual abuse. Women's health when starting in group therapy.

Childhood sexual abuse has been shown to be common among adult women, 15-30% in prevalence studies, and among mentally ill women, 25-77%. These women often suffer from depression, anxiety, sexual and relationship problems. Suicide attempts and self-destructive behaviour are common. Within the Department of Psychiatry at Lund University Hospital, 45 women with experiences of childhood sexual abuse were offered a 2-year-long trauma-focused group therapy. They were well educated but 27% were unemployed. Nearly half of the group had made suicide attempts, 87% had had suicidal thoughts and, according to the questionnaire SCL-90, they were suffering from psychiatric symptoms significantly to a greater degree than both a general group and a clinical group with mixed diagnoses. According to the questionnaire ISSI, they were less well socially integrated than both a general group and a clinical group, and the degree of social adjustment according to the questionnaire SAS-SR was lower than in a general group. The study shows that childhood sexually abused women seeking therapy are a symptom-burdened group. These women probably need psychiatric treatment of a particular character. Special group therapy for these women can potentially improve their health.

A comparison of spiral computed tomography and latex agglutination D-dimer assay in acute pulmonary embolism using pulmonary arteriography as gold standard.

OBJECTIVE: To compare the diagnostic accuracy of contrast medium enhanced spiral computed tomography of the pulmonary arteries (s-CTPA) and a latex agglutination D-dimer assay in patients with suspected acute pulmonary embolism (PE) by using pulmonary arteriography (PA) and clinical follow-up as reference method. DESIGN: Ninety hemodynamically stable patients with symptoms of acute pulmonary embolism were prospectively evaluated with s-CTPA and pulmonary arteriography (PA) within 24 h from admission. Plasma D-dimer levels on admittance were analyzed using a rapid latex agglutination D-dimer assay. The outcome of D-dimer concentrations in plasma below 0.25 and 0.5 mg/l was studied. RESULTS: All PA and s-CTPA investigations were regarded as of acceptable diagnostic quality in a consensus reading. Thirty-three patients had a positive PA (37%). Three patients had false negative and two patients had false positive s-CTPA findings. s-CTPA had 91% sensitivity, 96% specificity, 94% positive predictive value (PPV) and 95% negative predictive value (NPV). The sensitivity and specificity for D-dimer below 0.5 mg/l were 79 and 88%, respectively. The PPV and NPV were 81 and 87%. If a cut-off level of 0.25 mg/l was used the corresponding figures were 91, 65, 63 and 92%. CONCLUSION: s-CTPA has a higher sensitivity and specificity than latex agglutination D-dimer. A cut-off level of 0.25 mg/l can be used as screening method, but s-CTPA must be performed to exclude false positive cases.