That same report also found that each year, an estimated two to four million American women are abused by an intimate partner. The National Center on Elder Abuse estimates that one to two million elderly persons, primarily women, experience abuse or neglect on an ongoing basis. Domestic violence is not only physical. It can include psychological abuse and witnessing another family member being abused. Women in abusive relationships often say that psychological abuse affects them more adversely than physical abuse.
Abuse also cuts across all socioeconomic, racial, ethnic, geographic and age groups.
But if you don't ask, your patients won't tell. Fewer than one in three abused patients discuss the trauma with a physician, according to a study published in the July-August 1997 issue of Journal of Emergency Medicine. Primary care physicians can miss the diagnosis because patients usually do not present with signs of acute trauma. Instead, victims of abuse may present with vague aches and pains, depression, anxiety, substance abuse or a history of suicide attempts. Even women who experienced abuse in the past may present with similar symptoms.