A CASE-CONTROL STUDY OF THE SEQUELAE OF CHILDHOOD SEXUAL ASSAULT IN ADULT PSYCHIATRIC-PATIENTS

Objective: To determine if there is any association between childhood sexual assault and maladaptive coping behaviour in adult life. Design: A case-control study. Setting and patients: Data from 707 psychiatric patients consecutively examined by one psychiatrist in a rural practi ce were analysed. Forty-four female patients who were victims of child hood sexual assault were identified and were age matched in a random m anner with 88 control patients who denied being sexually assaulted as children. Results: The two groups were similar in occupational level, employment and marital status, and the only diagnostic difference betw een them was that there was a trend in the sexually assaulted group fo r more of these patients to be diagnosed as having personality disorde r. On a variety of other outcome factors, however, the two groups diff ered widely. The sexually assaulted women were more frequently victims of domestic violence (odds ratio [OR], 6.4), made suicide attempts (O R, 3.4) and abused alcohol (OR, 3.0) or tranquillisers (OR, 4.6) more often than the non-assaulted women. There was a definite association b etween childhood sexual assault and maladaptive coping behaviour in ad ult life, although the association is not necessarily causal, and the childhood sexual assault may, in fact, be a symptom of familial neglec t. Conclusion: This study provides clear evidence of the need to follo w up victims of childhood sexual assault and reinforces the importance of enquiring about this trauma.