title: Characteristics of sexual assault in women with a major psychiatric diagnosis.
abstract: OBJECTIVE
  In a previous study of women who had been sexually assaulted, we reported a 26% prevalence of a major psychiatric diagnosis. The purpose of this study was to better characterize sexual assaults in women with a major psychiatric diagnosis.
  
  
  METHODS
  All female patients >or=15 years old with a complaint of sexual assault underwent a standardized history and physical examination by an upper-level resident in obstetrics and gynecology. Data were abstracted and verified. A psychiatric diagnosis was determined by history and by use of computer-linked medical records. Chi-square or Fisher exact test was used for categoric analysis.
  
  
  RESULTS
  Of the 819 women who were examined, 211 women (26%) had a major psychiatric diagnosis. In these 211 women, the prevalence of solely mood, thought, or substance use disorders were 26%, 14%, and 16%, respectively, whereas 44% had >or=2 diagnoses. Having a psychiatric diagnosis was associated with increasing age (P =.001), homelessness (P =.001), and incarceration (P =.001). In comparison with women with no psychiatric diagnosis, sexual assaults in these 211 women occurred more frequently outdoors (P =.007), by a stranger (P <.001), or by >or=2 assailants (P =.02). Being assaulted with a weapon (P =.04) and being hit (P =.01) were more prevalent in assaults against women with a psychiatric diagnosis, as was anal contact (P =.03), contact to >or=2 body orifices (P =.001), and body trauma (P =.01).
  
  
  CONCLUSIONS
  Sexual assaults in women with a major psychiatric diagnosis are common. These assaults are more violent and result in body trauma more frequently than do sexual assaults in women without a psychiatric diagnosis. Prevention and treatment strategies should target this vulnerable population.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle, USA.
authors.forename: Linda O
authors.initials: LO
authors.lastname: Eckert
authors.forename: Naomi
authors.initials: N
authors.lastname: Sugar
authors.forename: David
authors.initials: D
authors.lastname: Fine
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000209:etiology*; D012016:Reference Values; D012742:Sex Offenses / Q000523:psychology*; D014754:Violence; D014947:Wounds and Injuries / Q000209:etiology