title: Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis.
abstract: OBJECTIVE
  To systematically assess the evidence for an association between sexual abuse and a lifetime diagnosis of psychiatric disorders.
  
  
  METHODS
  We performed a comprehensive search (from January 1980-December 2008, all age groups, any language, any population) of 9 databases: MEDLINE, EMBASE, CINAHL, Current Contents, PsycINFO, ACP Journal Club, CCTR, CDSR, and DARE. Controlled vocabulary supplemented with keywords was used to define the concept areas of sexual abuse and psychiatric disorders and was limited to epidemiological studies. Six independent reviewers extracted descriptive, quality, and outcome data from eligible longitudinal studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled across studies by using the random-effects model. The I(2) statistic was used to assess heterogeneity.
  
  
  RESULTS
  The search yielded 37 eligible studies, 17 case-control and 20 cohort, with 3,162,318 participants. There was a statistically significant association between sexual abuse and a lifetime diagnosis of anxiety disorder (OR, 3.09; 95% CI, 2.43-3.94), depression (OR, 2.66; 95% CI, 2.14-3.30), eating disorders (OR, 2.72; 95% CI, 2.04-3.63), posttraumatic stress disorder (OR, 2.34; 95% CI, 1.59-3.43), sleep disorders (OR, 16.17; 95% CI, 2.06-126.76), and suicide attempts (OR, 4.14; 95% CI, 2.98-5.76). Associations persisted regardless of the victim's sex or the age at which abuse occurred. There was no statistically significant association between sexual abuse and a diagnosis of schizophrenia or somatoform disorders. No longitudinal studies that assessed bipolar disorder or obsessive-compulsive disorder were found. Associations between sexual abuse and depression, eating disorders, and posttraumatic stress disorder were strengthened by a history of rape.
  
  
  CONCLUSIONS
  A history of sexual abuse is associated with an increased risk of a lifetime diagnosis of multiple psychiatric disorders.
authors.affiliation: Mayo Medical School, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Chen
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
authors.forename: Molly L
authors.initials: ML
authors.lastname: Paras
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Colbenson
authors.forename: Amelia L
authors.initials: AL
authors.lastname: Sattler
authors.forename: Erin N
authors.initials: EN
authors.lastname: Goranson
authors.forename: Mohamed B
authors.initials: MB
authors.lastname: Elamin
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Seime
authors.forename: Gen
authors.initials: G
authors.lastname: Shinozaki
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Prokop
authors.forename: Ali
authors.initials: A
authors.lastname: Zirakzadeh
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D003863:Depression / Q000453:epidemiology; D015340:Epidemiologic Research Design; D001068:Feeding and Eating Disorders / Q000453:epidemiology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D012893:Sleep Wake Disorders / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D013406:Suicide, Attempted / Q000706:statistics & numerical data
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