Is there a specific relationship between childhood sexual and physical abuse and repeated suicidal behavior?
OBJECTIVE
Studies show that childhood sexual and physical abuse predict repeated suicide attempts and self-mutilation. Little is known about the importance of sexual and physical abuse when compared to other severe childhood adversities with respect to chronic suicidal behavior.


METHODS
Seventy-four subjects, 65% of whom were women, consecutively admitted to a general hospital after having made a suicide attempt, were interviewed as part of the intake interview about prior suicide attempts and self-mutilation and received DSM-IV diagnoses. Sexual abuse, physical abuse, neglect, antipathy from parents, loss of parents, and severe discord in the family before the age of 18, were covered by the Childhood Experience of Care and Abuse (CECA) interview schedule.


RESULTS
The prevalence of severe sexual abuse was 35%, severe physical abuse 18%, neglect 27%, antipathy 34%, loss of caregiver 37% and exposure to family violence 31%. Physical and sexual abuse were independently associated with repeated suicide attempts when controlling for the effects of the other childhood adverse factors. No other childhood adversity was related to chronic suicidal behavior. The odds ratio of exposure to sexual or physical abuse was highest among those who both repeated suicide attempts and self-mutilated.


CONCLUSIONS
Physical and sexual abuse are significantly and independently associated with repeated suicidal behavior.
Ystgaard
Mette
M
Suicide Research and Prevention Unit, Sognsvannsveien 21, Building 12, University of Oslo, NO-0320 Oslo, Norway.
Hestetun
Ingebjørg
I
Loeb
Mitchell
M
Mehlum
Lars
L
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012652:Self Mutilation / Q000453:epidemiology / Q000523:psychology; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*