Effects of childhood sexual abuse in adult female psychiatric patients

Objective: The present case-control study investigated the relationship between a history of childhood sexual abuse and subsequent psychopathology. Methods: Referrals to a female psychiatrist in private practice in an urban working class area provided 73 adult female study subjects who reported having been sexually abused in childhood, and 73 randomly selected controls. Results: Subjects had earlier onset of psychiatric disorders and higher incidence of deliberate self-harm, rape in adulthood, and psychiatric hospitalisation. History of childhood sexual abuse had an effect independent of family psychiatric disorder. Although subjects and controls had a similar range of diagnoses, subjects were more likely to suffer anxiety disorders and controls more likely to suffer mood disorders. Controls were more likely to be prescribed antidepressants and subjects were more likely to receive supportive psychotherapy. Despite significantly lower initial Global Assessment of Functioning scores, subjects at completion of treatment had improved to the same scores as controls. Conclusion: The long-term effect of childhood sexual abuse is increased incidence of deliberate self-harm and is unrelated to any specific diagnosis. Despite more severe initial impairment, psychotherapy was effective for patients with a history of childhood sexual abuse.