Childhood sexual abuse and supportive factors.
BACKGROUND
Childhood sexual abuse (CSA) can be a devastating life experience and is associated with a higher incidence of mental disorders and suicide attempts. The aim of this study was therefore to identify predictors of mental disorder and suicide attempt in children and adolescents with a history of CSA.


METHODS
A total of 181 Turkish children and adolescents with a history of CSA were evaluated for age, gender, suicide attempts, family relationships and educational background. Abuse involving the insertion of an organ or foreign object into the individual's body was designated as "qualified sexual abuse" (QSA); other forms of sexual abuse were designated "basic sexual abuse" (BSA).


RESULTS
Suicide attempts were significantly higher in adolescent girls in the QSA subgroup; age, gender, family integrity, and school attendance were not associated with risk of mental disorders in this group. Among BSA patients, family integrity was significantly associated with suicide attempts. Suicide attempts were approximately 10-fold higher (OR, 10.154; 95% CI: 2.020-51.051; P = 0.005) in children from broken families. Family integrity and school attendance were also noted as weak protective factors against mental disorders in BSA patients. The incidence of mental disorders was 3.5-fold higher in children who had not been attending school (OR, 3.564; 95% CI: 1.379-9.211; P = 0.009).


CONCLUSIONS
Family integrity and school attendance were weakly related with psychopathology (e.g. mental disorders or suicide attempts) in BSA survivors but not in QSA survivors. Female gender and puberty also increased the likelihood of suicide attempt in QSA survivors.
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Muharrem Burak
MB
Baytunca
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Emsal
E
Ata
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Burcu
B
Ozbaran
Department of Forensic Medicine, School of Medicine, Ege University, Izmir, Turkey.
Ahsen
A
Kaya
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Sezen
S
Kose
Department of Forensic Medicine, School of Medicine, Ege University, Izmir, Turkey.
Ekin Ozgur
EO
Aktas
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Rezzan
R
Aydın
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Selcen
S
Guney
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Zeki
Z
Yuncu
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Serpil
S
Erermis
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Tezan
T
Bildik
Department of Child and Adolescent Psychiatry, School of Medicine, Ege University, Izmir, Turkey.
Cahide
C
Aydin
D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D014421:Turkey
child; family; school; sexual abuse; suicide