[What can the physician do when faced with the gigantic puzzle of abuse?].

Abstract

The entire subject of abuse can be compared to a gigantic puzzle were patients as well as their physicians get lost. The goal of this article is first to find a common definition to all acts of abuse and then to subdivide them into three distinct categories: sexual, physical, and emotional abuse. The treating physician should realize that victims of abuse, after the passage of time, will eventually fall sick and consult a doctor for physical or/and psychological symptoms which are the result of the past abuse. Most of the time, these patients will not speak spontaneously of the abuse, either because they have not understood the cause/effect relation, or because the abuse feels unspeakable. It is therefore necessary for the doctor to know how to detect abuse through symptomatology, how to help these patients reveal their secret, how to listen with a non-judgemental ear, and how to propose appropriate treatment.