Psychosis risk substantially increased by childhood sexual abuse
MedWire News: Children who suffer sexual abuse before the age of 16 have an increased risk for developing psychosis, say UK researchers who note that their findings highlight opportunities for the targeted prevention of mental illness.
There is increasing evidence of an association between childhood sexual abuse and psychosis, writes the team. This is of particular importance given that the prevalence of childhood sexual abuse is estimated to be as high as 11%.
To investigate further, Paul Bebbington (Royal Free & University College Medical School, London) and colleagues analyzed data for 7353 participants in the 2007 Adult Psychiatric Morbidity Survey in England. This was a random sample of household residents (aged ≥16 years) who lived in private accommodation.
The team reports in the British Journal of Psychiatry that all forms of sexual abuse, from uncomfortable sexual talk to non-consensual sexual intercourse, were significantly associated with the development of psychosis before adjusting for confounders.
In logistic regression analysis, uncomfortable sexual talk alone was not significantly associated with psychosis. However, there was a strong association between non-consensual sexual intercourse and psychosis, at an odds ratio of 10.14.
When the researchers considered different levels of abuse, the odds ratios for developing psychosis were 1.25, 1.61, and 10.66 for uncomfortable talk only, touching, and non-consensual intercourse, respectively, as compared with no abuse. These relationships remained significant after adjusting for sociodemographic factors.
The team found that cannabis use was not associated with childhood sexual abuse and psychosis. Depression and anxiety scores, however, were significantly increased in participants who had experienced contact abuse before 16 years of age compared with those who had not, and depression and anxiety were both associated with psychosis, at odds ratios of 1.6 and 1.5, respectively.
Non-consensual sexual intercourse in childhood strongly predicted adult non-consensual sexual intercourse, at an odds ratio of 8.72. Furthermore, the repetition of non-consensual sexual intercourse in adulthood increased the odds ratio of developing psychosis from 10.14 to 17.65, while repetition of contact abuse increased the odds from 3.49 to 10.78.
Bebbington et al say: "The increased risk of psychosis may be linked to the intrusive nature of childhood sexual abuse and having no control over what is happening to you."
They add: "Victims commonly describe sexual abuse as being accompanied by demands for secrecy and threats if the secrecy is broken, blocking effective social engagement and leading to isolation that itself leads to the development of psychotic symptoms."
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By Liam Davenport