Sexual abuse and lifetime diagnosis of psychiatric disorders: Systematic review and meta-analysis

Laura P. Chen, M. Hassan Murad, Molly L. Paras, Kristina M. Colbenson, Amelia L. Sattler, Erin N. Goranson, Mohamed B. Elamin, Richard J. Seime, Gen Shinozaki, Larry J. Prokop, Ali Zirakzadeh

Research output: Contribution to journalArticlepeer-review

477 Scopus citations

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). 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.

Original languageEnglish (US)
Pages (from-to)618-629
Number of pages12
JournalMayo Clinic proceedings
Volume85
Issue number7
DOIs
StatePublished - Jul 2010

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Sexual abuse and lifetime diagnosis of psychiatric disorders: Systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this