Baboolal N S, Lalla S, Chai M, Curtis R, Nandwani C, Olivier L, Smith C
Psychiatry Unit, Department of Clinical Medical Sciences, Faculty of Medical Sciences, St Augustine, The University of the West Indies.
West Indian Med J. 2007 Mar;56(2):152-8. doi: 10.1590/s0043-31442007000200009.
Only a few studies have focussed on the importance of routine investigation of childhood sexual abuse in outpatients attending adult psychiatric outpatient clinics. The aim of this study is to explore the association between having a history of childhood sexual abuse (CSA) and attending adult Psychiatric Outpatient Clinics in Trinidad.
This was a case-control study conducted in twelve psychiatric outpatient clinics located throughout Trinidad A questionnaire covering demographic, social, and sexual abuse components was administered by semi-structured interview to 566 participants, of whom 242 were cases, 239 were controls and 85 had incomplete questionnaires. The cases were 242 patients attending psychiatric outpatient clinics in Trinidad and the controls were 239 non-physician staffmembers at the clinics. Results were analyzed using the Stastistical Package for the Social Sciences (SPSS) version 10.
Chi-square analyses revealed several significant differences between the cases and control group. Sixty-three (26%) cases and 29 (12.1%) controls experienced CSA (p < 0.000). Twenty-five (39.7%) of the CSA cases had their experiences between the ages of 4 to 8 years and 13 (44.8%) of the CSA controls had their experiences between the ages of 9 to 12 (p < 0.01). Twenty-six (41.3%) of the cases and 3 (10.3%) of the controls had been abused at least 5 times (p < 0.000). Seventeen (58.6%) abused CSA controls reported having been sexually abused as a child only once. CSA with both force and manipulation was reported by 30 (47.6%) CSA cases while 6 (20.7%) CSA controls experienced CSA with force and manipulation (p < 0. 025). The abused CSA cases reported having a smaller social network of 2 persons compared to the abused CSA controls who had a social network of more than 4 persons (p < 0. 05). Of the 92 abused participants, 73.9% were women, and only 52.2% had told someone about the CSA. For the majority of CSA cases and CSA controls, the abuse involved one abuser.
A positive correlation was established between earlier onset of CSA, repeated abuse (occurring more than 5 times), a limited social network in patients who had CSA and attending adult psychiatric outpatient clinics. Identifying CSA in psychiatric outpatients may lead to early intervention and aid patient management.
仅有少数研究关注在成人精神科门诊就诊的门诊患者中对儿童性虐待进行常规调查的重要性。本研究的目的是探讨特立尼达岛有儿童性虐待（CSA）史与在成人精神科门诊就诊之间的关联。
这是一项在特立尼达岛各地的12家精神科门诊进行的病例对照研究。通过半结构化访谈，向566名参与者发放了一份涵盖人口统计学、社会和性虐待内容的问卷，其中242人为病例组，239人为对照组，85人问卷不完整。病例组为在特立尼达岛精神科门诊就诊的242名患者，对照组为门诊的239名非医务人员。使用社会科学统计软件包（SPSS）10版对结果进行分析。
卡方分析显示病例组和对照组之间存在若干显著差异。63例（26%）病例和29例（12.1%）对照经历过CSA（p<0.000）。25例（39.7%）CSA病例的性虐待经历发生在4至8岁之间，13例（44.8%）CSA对照的性虐待经历发生在9至12岁之间（p<0.01）。26例（41.3%）病例和3例（10.3%）对照至少被虐待过5次（p<0.000）。17例（58.6%）受虐待的CSA对照报告儿童期仅遭受过一次性虐待。30例（47.6%）CSA病例报告遭受过暴力和操纵性的CSA，而6例（20.7%）CSA对照经历过暴力和操纵性的CSA（p<0.025）。与社交网络超过4人的受虐待CSA对照相比，受虐待的CSA病例报告社交网络较小，仅2人（p<0.05）。在92名受虐待参与者中，73.9%为女性，只有52.2%的人曾向他人讲述过CSA情况。对于大多数CSA病例和CSA对照，虐待涉及一名施虐者。
CSA发病较早、多次受虐（超过5次）、有CSA的患者社交网络有限与在成人精神科门诊就诊之间存在正相关。在精神科门诊患者中识别CSA可能会带来早期干预并有助于患者管理。
