Detecting child sexual abuse in general practice: a retrospective case-control study from Wales.
OBJECTIVE
To investigate if routine medical contacts provide indicators that would assist general practitioners in detecting male child abuse.


METHODS
A case-control study of the general practice records of male victims of a major episode of school-based child abuse and matched controls.


METHODS
General practices serving cases and controls from two South Wales schools.


METHODS
107 abused boys and 107 aged-matched controls.


RESULTS
No boys had disclosed sexual abuse to general practitioners. Somatic and behavioural symptoms were reported by small numbers in both groups (18 cases/25 controls). Odds ratios showed no significant positive association between abuse and numbers of boys presenting with symptoms (odds ratio 0.66; 95% confidence interval 0.32-1.37), and no difference could be found in the nature of the symptoms complained of by boys from the two groups. However, abused boys were more likely than controls to present with symptoms that persisted for more than a year (eight cases compared with one control). The two-tailed p-value calculated using the Fisher exact test was 0.035, suggesting a statistically significant association between abuse and persistent symptoms.


CONCLUSIONS
Sexually-abused boys are unlikely to visit general practitioners with open requests for help, and do not appear to present with behavioural or somatic symptoms different from those presented by non-abused boys. However, where boys complain of persistent, inexplicable, somatic or behaviour problems over a period of time, the possibility of abuse should be considered.
Maddocks
A
A
Department of Community Child Health, Swansea NHS Trust, Wales, UK.
Griffiths
L
L
Antao
V
V
D016022:Case-Control Studies; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis* / Q000523:psychology; D016001:Confidence Intervals; D005194:Family Practice; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010378:Pedophilia; D012189:Retrospective Studies; D014852:Wales / Q000453:epidemiology