Childhood sexual abuse among outpatients attending adult psychiatric outpatient clinics: a case-control study.
Only a few studies have focussed on the importance of routine investigation of childhood sexual abuse in outpatients attending adult psychiatric outpatient clinics. The aim of this study is to explore the association between having a history of childhood sexual abuse (CSA) and attending adult Psychiatric Outpatient Clinics in Trinidad.


METHODS
This was a case-control study conducted in twelve psychiatric outpatient clinics located throughout Trinidad A questionnaire covering demographic, social, and sexual abuse components was administered by semi-structured interview to 566 participants, of whom 242 were cases, 239 were controls and 85 had incomplete questionnaires. The cases were 242 patients attending psychiatric outpatient clinics in Trinidad and the controls were 239 non-physician staffmembers at the clinics. Results were analyzed using the Stastistical Package for the Social Sciences (SPSS) version 10.


RESULTS
Chi-square analyses revealed several significant differences between the cases and control group. Sixty-three (26%) cases and 29 (12.1%) controls experienced CSA (p < 0.000). Twenty-five (39.7%) of the CSA cases had their experiences between the ages of 4 to 8 years and 13 (44.8%) of the CSA controls had their experiences between the ages of 9 to 12 (p < 0.01). Twenty-six (41.3%) of the cases and 3 (10.3%) of the controls had been abused at least 5 times (p < 0.000). Seventeen (58.6%) abused CSA controls reported having been sexually abused as a child only once. CSA with both force and manipulation was reported by 30 (47.6%) CSA cases while 6 (20.7%) CSA controls experienced CSA with force and manipulation (p < 0. 025). The abused CSA cases reported having a smaller social network of 2 persons compared to the abused CSA controls who had a social network of more than 4 persons (p < 0. 05). Of the 92 abused participants, 73.9% were women, and only 52.2% had told someone about the CSA. For the majority of CSA cases and CSA controls, the abuse involved one abuser.


CONCLUSIONS
A positive correlation was established between earlier onset of CSA, repeated abuse (occurring more than 5 times), a limited social network in patients who had CSA and attending adult psychiatric outpatient clinics. Identifying CSA in psychiatric outpatients may lead to early intervention and aid patient management.
Baboolal
N S
NS
Psychiatry Unit, Department of Clinical Medical Sciences, Faculty of Medical Sciences, St Augustine, The University of the West Indies. nbaboolal@fms.uwi.tt
Lalla
S
S
Chai
M
M
Curtis
R
R
Nandwani
C
C
Olivier
L
L
Smith
C
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010045:Outpatients / Q000523:psychology*; D010865:Pilot Projects; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014300:Trinidad and Tobago / Q000453:epidemiology