Abuse and deliberate self-poisoning in women: a matched case-control study

Objective: Controlled studies have shown deliberate self-harm to be more co mmon in abused populations, but no controlled studies have shown abuse to b e more common in self-harming populations. This is the first controlled stu dy to determine whether abuse experiences (sexual, physical, and psychologi cal) occurred more commonly in women who take overdoses than in controls. Method: The design was a matched (1: 1) case-control study Set in a distric t general hospital in England. The subjects were 36 women admitted followin g deliberate self-poisoning. They were matched with the next non-overdose a dmission to the same hospital on six variables (sex, age, ethnicity, social class, marital status, and geographical locality). The main outcome measur es used were modified versions of standardized self-report questionnaires o f sexual, physical, and psychological abuse, to-ether with measures of pare nting style and general psychopathology. Results: Women who had taken an overdose were more likely (odds ratio 15.0, 95% confidence interval 2.0 to 113.6) to have been sexually abused, and so mewhat more likely to have been psychologically (1.02, 1.00 to 1.05) but no t physically abused. They also had higher measures of psychopathology (GHQ- 30: 1.19, 1.07 to 1.31), were more likely to have been abused at a younger age. exposed to the "affectionless control" style of parenting by their mot hers, and to have harmed themselves in other ways. Conclusions: The management of women presenting to hospital after self-pois oning should include assessment of abuse experiences, and instigation of ap propriate treatment in those with significant sequelae of abuse. (C) 2001 E lsevier Science Ltd. All rights reserved.