Relation between sexual abuse in childhood and adult depression: case-control study

BMJ 1998;316:198-201 (17 January)

General practice

Relation between sexual abuse in childhood and adult depression: case-control study

Marese Cheasty, senior registrar in psychiatry,^a Anthony W Clare, medical director of hospital,^a Claire Collins, data analyst ^a

^a St Patrick's Hospital, James's Street, Dublin 8, Republic of Ireland

Correspondence to: Dr Cheasty dpn@iol.ie

Objective: To examine the association between sexual abuse inchildhood and adult depression in women.
Design: Two stage, case detection and case identification design,using the 30-item general health questionnaire and the Beckdepression inventory for screening and the affective items relatingto current functioning on the schizophrenia and affective disordersschedule to identify depressed cases. Details of sexual abusein childhood were elicited retrospectively by semistructuredinterview, and social problems by the social problems questionnaire.
Setting: Three general practices, in middle class suburban,deprived inner city, and rural areas.
Subjects: 1189 women were screened and 237 subsequently interviewed;132 were depressed.
Results: 49 (37%) of the depressed interviewees and 24 (23%)of the non-depressed interviewees reported experience of sexualabuse when they were aged under 16 years. A positive associationexisted between the more severe abuse and depression—allthose who had experienced penetration were depressed as adults.A relation was also found between sexual abuse in childhoodand sexual problems, housing problems, and problems with theirchildren at school.
Conclusion: A positive association between child sexual abuseand depression was confirmed, but this was confined to moresevere abuse (penetration or attempted penetration).

Key messages

Most researchers agree that a significant association exists between childhood sexual abuse and increased psychopathology as an adult
The relation between sexual abuse in childhood and adult depression, however, has been unclear
This study shows a positive association between severe sexual abuse (penetration or attempted penetration) in childhood and depression in adult life
Women who had experienced more minor sexual abuse in childhood, however, were no more likely to be depressed than those with no history of sexual abuse

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Sexual abuse is not the only childhood adversity that may lead to later depression: Paul A Cotter
BMJ 1998 316: 1244. [Extract] [Full Text]

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