Journal Article

Sexual abuse and lifetime diagnosis of psychiatric disorders

Mayo Clinic Proceedings

Chen, Laura P., Murad Hassan M., Paras Molly L., Colbenson Kristina M., Sattler Amelia L., & Goranson Erin N.
Volume2011
IssueJuly 31, 2011
Type of WorkResearch Report

Systematic review and meta-analysis

Abstract

Objective 

To systematically assess the evidence for an association between

  • sexual abuse and
  • a lifetime diagnosis of psychiatric disorders.

Patients and methods 

We performed a comprehensive search 

(from January 1980-December 2008, all age groups, any language, any population) 

of 9 databases: MEDLINE, EMBASE, CINAHL, Current Contents, PsycINFO, ACP Journal Club, CCTR, CDSR, and DARE. Controlled vocabulary supplemented with keywords was used to define the concept areas of sexual abuse and psychiatric disorders and was limited to epidemiological studies. 

Six independent reviewers extracted descriptive, quality, and outcome data from eligible longitudinal studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled across studies by using the random-effects model. The I2 statistic was used to assess heterogeneity.

Results 

The search yielded 37 eligible studies, 17 case-control and 20 cohort, with 3,162,318 participants. 

There was a statistically significant association between sexual abuse and a lifetime diagnosis of

  • anxiety disorder (OR, 3.09; 95% CI, 2.43-3.94),
  • depression (OR, 2.66; 95% CI, 2.14-3.30),
  • eating disorders (OR, 2.72; 95% CI, 2.04-3.63),
  • posttraumatic stress disorder (OR, 2.34; 95% CI, 1.59-3.43),
  • sleep disorders (OR, 16.17; 95% CI, 2.06-126.76), and
  • suicide attempts (OR, 4.14; 95% CI, 2.98-5.76).

CI = confidence interval; OR = odds ratio; PTSD = posttraumatic stress disorder

Associations persisted regardless of the victim's sex or the age at which abuse occurred.

There was no statistically significant association between sexual abuse and a diagnosis of

  • schizophrenia or
  • somatoform disorders.

No longitudinal studies that assessed

  • bipolar disorder or 
  • obsessive-compulsive disorder

were found. 

Associations between sexual abuse and

  • depression, 
  • eating disorders, and 
  • posttraumatic stress disorder

were strengthened by a history of rape.

Conclusion 

A history of sexual abuse is associated with an increased risk of a lifetime diagnosis of multiple psychiatric disorders.