What are the needs of alcohol dependent patients with a history of sexual violence? A case-register study in a metropolitan region.
BACKGROUND
Sexual violence has become increasingly apparent as a factor determining more complex treatment needs in patients with substance abuse. However, empirical evidence on specific patterns of differences between patients with and without a history of sexual violence is scarce.


METHODS
Our sample consisted of alcohol dependent outpatients treated during a two-year period in a German metropolitan region. The analysis was based on a local case register and included all patients for whom information on lifetime sexual violence was available (N=1981; 33.4% female). In a case-control design, patients with a history of sexual violence were compared to patients without such experiences regarding a wide range of clinical and social factors indicative of potential needs.


RESULTS
More than 35% of the female patients and 6% of the male patients reported a history of sexual violence. Victims differed from non-victims across a variety of domains, including psychiatric symptoms and suicide attempts, legal problems, financial and family problems, previous use of services, and need for additional services during the current treatment. Patient gender emerged as a significant moderator of several of these associations.


CONCLUSIONS
The findings indicate that an effort needs to be made to link addiction treatment, other parts of the health care system, and further institutions, such as family services and parts of the legal system, so that the complex needs of this vulnerable population can be met in an adequate way.
Schäfer
Ingo
I
Department of Psychiatry and Psychotherapy, University Medical Center, Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany. i.schaefer@uke.uni-hamburg.de
Verthein
Uwe
U
Oechsler
Harald
H
Deneke
Christiane
C
Riedel-Heller
Steffi
S
Martens
Marcus
M
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D016022:Case-Control Studies; D002648:Child; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data; D003415:Crime; D017831:Diagnosis, Dual (Psychiatry); D004651:Employment; D005190:Family; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D008875:Middle Aged; D012737:Sex Factors; D012742:Sex Offenses / Q000523:psychology* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D014505:Urban Population; D014754:Violence