Your doctor gives you a choice: prolonged life or rapid decline. If you are an abuse victim, a recent National Institutes of Health-funded study indicates, you might choose decline.

David W. Pantalone, a clinical psychologist at Suffolk University, studied 171 HIV-positive gay men. Each month, abused men skipped nearly 20 percent of their HIV medications. Pantalone links statistically abuse, psychological distress, and poor physical health.

“The world dichotomizes mental and physical health, but we know that isn’t really so,” Pantalone says. He looked at interpersonal violence, such as child and partner abuse and tied this violence to mental health: symptoms of depression, anxiety, and posttraumatic stress disorder. Then, using a 700-question survey and data pulled directly from participants’ electronic medical records, he measured physical health by looking at the frequency of emergency room visits, reports of physical injury and chronic pain, and missed HIV medication doses.

The results: those who experienced interpersonal abuse suffered later in life.

“The stories are really sad,” Pantalone says. He remembered one man with a crystal methamphetamine addiction, facilitated by his partner, and another who suffered physical violence, escalating to rape. “In one case, the final straw was when his partner tied him down to a chair and slit his throat,” Pantalone said. “I asked him how he was possibly still alive. He had been living in an apartment building and knocked over his chair so that he would bleed into the hallway… so that someone could find him.”

It’s not a rare problem. Pantalone points to a 2004 Centers for Disease Control report showing that 25 percent of all American women suffer such abuse. Though he focused on gay, HIV-infected men, Pantalone calls the path from psychological distress to poor physical health “a universal process.”

To Pantalone, these results mean that physicians and psychologists should look closely for past abuse when presented with health problems. He also sees the need for a more comprehensive approach to psychological research.

“The rape people don’t talk to the child abuse people, who don’t talk to the partner abuse people,” he says, “but we know that people who experience one kind of violence are at a significantly increased risk for experiencing it somewhere else.”

Studies such as Pantalone’s continue to establish a statistical link between abuse, mental anguish, and physical health. Now Pantalone believes doctors must treat patients accordingly, “When it’s just a statistic, it’s easy to forget what it means… it’s much harder when it’s people’s lives.”