ORIGINAL ARTICLESexual Abuse and Lifetime Diagnosis of Psychiatric Disorders: Systematic Review and Meta-analysis
Section snippets
Data Sources and Searches
The protocol for this systematic review was developed by physicians and researchers in internal medicine, preventive medicine, epidemiology, statistics, and psychology. Methods described by the Cochrane Collaboration were used in the development of the protocol.21 The reporting of results was based on the recommendations of the Meta-analysis of Observational Studies in Epidemiology group.22
We performed a comprehensive search (from January 1980-December 2008, all age groups, any language, any
Study Characteristics
This systematic review yielded 37 studies, 17 case-control and 20 cohort, with 3,162,318 participants (Figure 1).7, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64 Twenty-seven studies assessed childhood abuse, one study assessed adult abuse, and 2 studies assessed adult and childhood abuse separately. The remaining 7 studies did not stratify or report the age at which abuse occurred. Sixteen studies
DISCUSSION
This comprehensive systematic review and meta-analysis of 37 longitudinal observational comparative studies including 3,162,318 participants found an association between a history of sexual abuse and a lifetime diagnosis of anxiety, depression, eating disorders, PTSD, sleep disorders, and suicide attempts. There was no statistically significant association between a history of sexual abuse and a lifetime diagnosis of schizophrenia or somatoform disorders. Association between sexual abuse and
CONCLUSION
Survivors of sexual abuse are commonly encountered in general medical practice. It is now known that sexual abuse survivors face a challenging spectrum of physical and mental health concerns, with associated higher health care use and greater medical expenditures. This systematic review and meta-analysis demonstrates that sexual abuse is associated with multiple psychiatric disorders, including lifetime diagnosis of anxiety disorders, depression, eating disorders, PTSD, sleep disorders, and
Acknowledgments
We are grateful to the Mayo Clinic librarians for their indispensable assistance in the search strategy and review process. We also thank the investigators who were kind enough to forward their unpublished data to us.
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An earlier version of this article appeared Online First.
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Dr Shinozaki is now with the VA Medical Center, Sioux Falls, SD