title: The Psychiatric Consequences of Child and Adolescent Sexual Abuse.
abstract: BACKGROUND
  The purpose of this study was to investigate the psychiatric consequences of sexual abuse and its associated factors in children and adolescents referred to our child and adolescent psychiatry clinic from official medico-legal units.
  
  
  METHODS
  All victims of sexual abuse (n=590) aged 1-18 (mean: 13.56±3.38) referred from forensic units to Ondokuz Mayis University Child and Adolescent Psychiatry Clinic over a period of 2 years [boys: 83 (14.1%); girls: 507 (85.9%)] were included. Child and adolescent psychiatry and forensic medicine specialists evaluated all the cases. The Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T) were applied.
  
  
  RESULTS
  Abuse-related psychiatric diagnoses (of which 45.9% were major depressive disorder and 31.7% were post-traumatic stress disorder cases) were made in 75.2% of the cases. In 80.3% of the cases, the perpetrators were known to their victims [incest, n=91 (15.1%)], and intercourse took place in 48.8%. Although gender and age were not significantly associated with the appearance of any psychiatric disorders, severity of abuse (e.g., intercourse; p=.006), additional physical assault (p<.001), and incest (p<.001) had a significant correlation with psychiatric disorders. To explore the predictive value of multiple factors in the appearance of any sexual assault-related psychiatric disorder, a logistic regression model was used to determine the best linear combination of age, gender, abuse severity, incest, involvement of any other victim, additional physical assault, and length of time from first abuse to first psychiatric evaluation. This combination of variables (occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation) significantly predicted the appearance of a psychiatric disorder of any kind (χ2=55.42; df=7; n=522; p<.001).
  
  
  CONCLUSIONS
  Our findings reveal that the occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation predict higher rates of sexual abuse-related psychiatric disorders.
authors.affiliation: Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yüce
authors.affiliation: Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Koray
authors.initials: K
authors.lastname: Karabekiroğlu
authors.affiliation: Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Yildirim
authors.affiliation: Clinic of Child and Adolescent Psychiatry, Balıkesir Atatürk State Hospital, Balıkesir, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Şahin
authors.affiliation: Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Dicle
authors.initials: D
authors.lastname: Sapmaz
authors.affiliation: Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Babadaği
authors.affiliation: Department of Forensic Medicine, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Turla
authors.affiliation: Department of Forensic Medicine, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Aydin
keywords: Child sexual abuse; children and adolescence; psychiatric outcomes; trauma