BPDFamily.com reports that a study published in the November Archives of General Psychiatry suggests that children who are sexually abused may be at twice the risk for developing schizophrenia and other psychotic disorders.
In this study, Margaret C. Cutajar of Monash University, Victoria, Australia, and colleagues linked data from police and medical examinations of sexual abuse cases to a statewide register of psychiatric cases. They compared the rates of psychiatric disorders among 2,759 individuals who had been sexually abused when younger than age 16 to 4,938 random individuals. Over a 30-year period, individuals who had experienced childhood sexual abuse had more the twice the incidence of psychosis (2.8 percent vs. 1.4 percent) and schizophrenia disorders (1.9 percent vs. 0.7 percent).
This is consistent with prior studies studies that have established that abused children are more likely to develop depression, anxiety, substance abuse, borderline personality disorder, post-traumatic stress disorder and suicidal behavior, according to background information in the article. This study found that a history of sexual abuse with penetration especially increased the risk.
Participants experienced abuse at an average age of 10.2, and 1,732 (63 percent) of cases involved penetration of a bodily orifice by a penis, finger or other object. Those exposed to this type of abuse had higher rates of psychosis (3.4 percent) and schizophrenia (2.4 percent).
“The risks of subsequently developing a schizophrenic syndrome were greatest in victims subjected to penetrative abuse in the peripubertal and postpubertal years from 12 to 16 years and among those abused by more than one perpetrator,” the authors write.
“Children raped in early adolescence by more than one perpetrator had a risk of developing psychotic syndromes 15 times greater than for the general population.”
The results establish childhood sexual abuse as a risk factor for psychotic illness, but do not necessarily translate into abuse causing or increasing the risk of developing such a disease, the authors note. “The possibility of a link between childhood sexual abuse and later psychotic disorders, however, remains unresolved despite the claims of some that a causal link has been established to schizophrenia,” the authors write.
Many cases of childhood sexual abuse never come to light, and the overall population of abused children may be significantly different from those whose abuse is detected by officials.
“Establishing that severe childhood sexual abuse is a risk factor for schizophrenia does have important clinical implications irrespective of questions of causality and irrespective of whether those whose abuse is revealed are typical,” the authors conclude.
“Children who come to attention following childhood sexual abuse involving penetration, particularly in the peripubertal and postpubertal period, should receive ongoing clinical and social support in the knowledge that they are at greater risk of developing a psychotic illness.”
“Such treatment in our opinion should focus on improving their current functioning and adaptation to the demands of the transition from adolescent to adult roles rather than primarily on the abuse experience itself.
“Such an approach should benefit all victims, irrespective of whether they have the potential to develop a psychotic illness.”
The study is found in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Schizophrenia and Other Psychotic Disorders in a Cohort of Sexually Abused Children
Margaret C. Cutajar, DPsych, MAPS; Paul E. Mullen, DSc, FRANZCP, FRCPsych; James R. P. Ogloff, PhD; Stuart D. Thomas, PhD; David L. Wells, MA, FACLM; Josie Spataro, PhD, MAPS Arch Gen Psychiatry. 2010;67(11):1114-1119.
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