title: Childhood sexual abuse and psychosis: data from a cross-sectional national psychiatric survey in England.
abstract: BACKGROUND
  A number of studies in a range of samples attest a link between childhood sexual abuse and psychosis.
  
  
  OBJECTIVE
  To use data from a large representative general population sample (Adult Psychiatric Morbidity Survey 2007) to test hypotheses that childhood sexual abuse is linked to psychosis, and that the relationship is consistent with mediation by revictimisation experiences, heavy cannabis use, anxiety and depression.
  
  
  METHODS
  The prevalence of psychosis was established operationally in a representative cross-sectional survey of the adult household population of England (n = 7353). Using computer-assisted self-interview, a history of various forms of sexual abuse was established, along with the date of first abuse.
  
  
  RESULTS
  Sexual abuse before the age of 16 was strongly associated with psychosis, particularly if it involved non-consensual sexual intercourse (odds ratio (OR) = 10.14, 95% CI 4.8-21.3, population attributable risk fraction 14%). There was evidence of partial mediation by anxiety and depression, but not by heavy cannabis use nor revictimisation in adulthood.
  
  
  CONCLUSIONS
  The association between childhood sexual abuse and psychosis was large, and may be causal. These results have important implications for the nature and aetiology of psychosis, for its treatment and for primary prevention.
authors.affiliation: Department of Psychiatry & Behavioural Sciences, Royal Free & University College Medical School, Holborn Union Building, Archway Campus, Whittington Hospital, Highgate Hill, London N19 5LW, UK. p.bebbington@ucl.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Bebbington
authors.forename: Sarah
authors.initials: S
authors.lastname: Jonas
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.forename: Claudia
authors.initials: C
authors.lastname: Cooper
authors.forename: Traolach
authors.initials: T
authors.lastname: Brugha
authors.forename: Howard
authors.initials: H
authors.lastname: Meltzer
authors.forename: Sally
authors.initials: S
authors.lastname: McManus
authors.forename: Rachel
authors.initials: R
authors.lastname: Jenkins
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D002648:Child; D002650:Child Abuse, Sexual / Q000145:classification / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult