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Impact of child sexual abuse on mental health: Prospective study in males and females

  • Josie Spataro (a1), Paul E. Mullen (a2), Philip M. Burgess (a3), David L. Wells (a4) and Simon A. Moss (a4)...
Abstract
Background

The lack of prospective studies and data on male victims leaves major questions regarding associations between child sexual abuse and subsequent psychopathology.

Aims

To examine the association between child sexual abuse in both boys and girls and subsequent treatment for mental disorder using a prospective cohort design.

Method

Children (n=16L2; 1327 female) ascertained as sexually abused at the time had their histories of mental health treatment established by data linkage and compared with the general population of the same age over a specified period.

Results

Both male and female victims of abuse had significantly higher rates of psychiatric treatment during the study period than general population controls (12.4% v. 3.6%). Rates were higher for childhood mental disorders, personality disorders, anxiety disorders and major affective disorders, but not for schizophrenia. Male victims were significantly more likely to have had treatment than females (22.8% v. 10.2%).

Conclusions

This prospective study demonstrates an association between child sexual abuse validated at the time and a subsequent increase in rates of childhood and adult mental disorders.

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Copyright
Corresponding author
Professor Paul E. Mullen, Thomas Embling Hospital, Locked Bag 10, Fairfield, Victoria 3078, Australia. E-mail: paul.mullen@forensicare.vic.gov.au
Footnotes
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Declaration of interest

J.S. received an Australian Postgraduate Award. Additional funding detailed in Acknowledgements.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Impact of child sexual abuse on mental health: Prospective study in males and females

  • Josie Spataro (a1), Paul E. Mullen (a2), Philip M. Burgess (a3), David L. Wells (a4) and Simon A. Moss (a4)...
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eLetters

Would this qualify for a prospective study?

Nandini Chakraborty, SHO (Psychiatry)
04 June 2004

The title of this paper proclaims that the study was a prospective one. A prospective study, by definition, is one that looks into the futurewhen the research was started or planned. Though the authors have looked into the future mental health impact of child sexual abuse, it seems quiteobvious that the study itself was done with the data being collected retrospectively.

The authors have retrospectively identified their subjects by checking a register which records child sexual abuse. They have also retrospectively collected data regarding contact with the mental health services for a specified period (1 July 1991–30 June 2000). The methodology, other than being retrospective in nature, includes other flaws that have not been mentioned in the limitations of the study.

Since the subjects' contacts with psychiatric services have been studied over only a specific period of time, valuable data may have been lost if a subject presented earlier. What if some of the subjects had committed suicide before July 1991?

A lot of potential data seem to have been lost in this study, but theauthors admit the limitations, including the fact that some patients may have presented to the private sector and are thus not on the Victorian Psychiatric Case Register and that the diagnostic hierarchy used in the study may have skewed some of the results.

A proper prospective study might have been able to tell us more. If the subjects were identified at the beginning of the study and then tracedat the end of a specific follow up period, it might have been possible to pick up the subjects lost to the private sector, death or those who presented with a short lasting episode of mental illness before the periodof follow-up specified in the present study.
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Conflict of interest: None Declared

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