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 practice were analysed. Forty-four female patients who were victims of childhood sexual assault were identified and were age matched in a random manner 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 between them was that there was a trend in the sexually assaulted group for more of these patients to be diagnosed as having personality disorder. On a variety of other outcome factors, however, the two groups differed widely. The sexually assaulted women were more frequently victims of domestic violence (odds ratio [OR], 6.4), made suicide attempts (OR, 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 between childhood sexual assault and maladaptive coping behaviour in adult life, although the association is not necessarily causal, and the childhood sexual assault may, in fact, be a symptom of familial neglect. CONCLUSION This study provides clear evidence of the need to follow up victims of childhood sexual assault and reinforces the importance of enquiring about this trauma.