Acta Obstet Gynecol Scand. 2026 Jan 16. doi: 10.1111/aogs.70141. Online ahead of print.
ABSTRACT
INTRODUCTION: Somatization disorders belong to a category of psychiatric conditions in which psychological distress and impairment are manifested as physical symptoms. Affected patients tend to utilize specialist healthcare services more frequently and have more emergency visits than those without somatization. From a gynecological perspective, it is of relevance to investigate whether any specific somatic symptoms are linked to previous experience of physical, psychological, or sexual violence. The study aimed to explore whether any specific symptoms could be associated with level of somatization among women consulting a gynecologist; whether experience of physical, psychological, or sexual violence could be associated with level of somatization; and whether experience of violence is associated with self-rated state of health.
MATERIAL AND METHODS: A cross-sectional survey was conducted at three gynecological clinics in western Sweden between February and May 2024. A project-specific questionnaire was distributed to women who consulted the clinic and completed in the waiting room. The survey consisted of 13 items, including sociodemographic variables, reasons for the current gynecological consultation, self-rated health, history of physical, psychological or sexual violence, discomfort during gynecological examination, and somatic symptom severity. Data were analyzed using descriptive statistics, chi-square tests, ANOVA, and multivariable linear regression analyses.
RESULTS: Of 2000 questionnaires distributed, 1766 were completed (response rate 88.3%). Among participants, 21.8% reported experience of sexual violence, 16.8% psychological violence, and 13.6% physical violence. Among those reporting any form of violence (n = 653), overlap was common: 236/653 (36.1%) had experienced only sexual violence, while 191/653 (29.2%) had experienced all three types. Somatic symptom severity was significantly associated with both sexual and psychological violence, but not physical violence. Clinical predictors of somatization included abdominal pain, dysmenorrhea, and multiple symptoms including pain. High somatic symptom severity was strongly associated with worse self-rated health. Somatic symptoms and specific consultation reasons, but not violence experiences, were significantly associated with self-rated health.
CONCLUSIONS: Somatization is common among women seeking gynecological care and is associated with a history of sexual and psychological violence. The findings underscore the importance of assessing underlying symptom patterns and the value of trauma-informed assessment to optimize patient management.
PMID:41545902 | DOI:10.1111/aogs.70141
