title: Prevalence and impact of childhood abuse in people with a psychotic illness. Data from the second Australian National Survey of Psychosis.
abstract: Child abuse has been associated with risk of mental illness, including schizophrenia and other psychotic disorders and, among those with mental illness, with a more severe clinical profile. Using an extensively characterised and epidemiologically representative sample of 1825 Australians with a psychotic illness aged 18-64 years and in contact with mental health services, we estimated the proportion of individuals with psychotic disorders who self-reported child abuse and examined its relationship with clinical and other characteristics. The prevalence of child abuse in this nationally representative sample of people with psychotic illness was 30.6%. Women were almost three times more likely to report child abuse compared to males (OR, 2.8, 95% CI 2.3-3.4). When adjusted for age at interview and socio-economic status, there was no significant relationship between self-reported child abuse and type of psychosis or course of illness. Participants with child abuse were significantly more likely to have subjective thought disorder, lifetime suicide attempt and premorbid personality disorder (females only) and anxiety (males only). Our findings demonstrate that child abuse is relatively common across the range of psychotic disorders, with an elevated risk for women in particular, compounding the already high burden associated with psychotic illness. Clinicians need to inquire routinely about child abuse in order to develop appropriate treatment plans tailored to individual needs.
authors.affiliation: Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia. Electronic address: sonal.shah@uwa.edu.au.
authors.forename: Sonal
authors.initials: S
authors.lastname: Shah
authors.affiliation: Orygen Youth Health Research Centre, Melbourne, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mackinnon
authors.affiliation: School of Medicine, University of Adelaide, Adelaide, SA, Australia; Ramsay Health Care (SA) Mental Health Services, Adelaide, SA, Australia; Northern Adelaide Local Health Network, Adelaide, SA, Australia.
authors.forename: Cherrie
authors.initials: C
authors.lastname: Galletly
authors.affiliation: School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia; Schizophrenia Research Institute, Sydney, NSW, Australia.
authors.forename: Vaughan
authors.initials: V
authors.lastname: Carr
authors.affiliation: Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, Brisbane, QLD, Australia.
authors.forename: John J
authors.initials: JJ
authors.lastname: McGrath
authors.affiliation: Centre for Rural and Remote Mental Health, University of Newcastle, Newcastle, NSW, Australia; School of Medicine, Pharmacy and Health, Durham University, Durham, UK.
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Stain
authors.affiliation: Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; St. Vincent's Hospital, Melbourne, VIC, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Castle
authors.affiliation: Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; Psychosocial Research Centre, North West Area Mental Health Services, Coburg, VIC, Australia.
authors.forename: Carol
authors.initials: C
authors.lastname: Harvey
authors.affiliation: School of Medicine, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Shaun
authors.initials: S
authors.lastname: Sweeney
authors.affiliation: Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia.
authors.forename: Vera A
authors.initials: VA
authors.lastname: Morgan
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D002649:Child Abuse; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology*; D012307:Risk Factors; D055815:Young Adult
keywords: Child abuse; Functioning; Gender differences; Interventions; Psychosis; Schizophrenia; Suicide