Yüce Murat, Karabekiroğlu Koray, Yildirim Zeynep, Şahin Serkan, Sapmaz Dicle, Babadaği Zehra, Turla Ahmet, Aydin Berna
Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.
Clinic of Child and Adolescent Psychiatry, Balıkesir Atatürk State Hospital, Balıkesir, Turkey.
Noro Psikiyatr Ars. 2015 Dec;52(4):393-399. doi: 10.5152/npa.2015.7472. Epub 2015 Dec 1.
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.
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.
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 (χ=55.42; df=7; n=522; p<.001).
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.
本研究旨在调查从官方法医学单位转介至我们儿童与青少年精神病诊所的儿童及青少年遭受性虐待的精神后果及其相关因素。
纳入了在两年期间从法医单位转介至翁多库兹马伊什大学儿童与青少年精神病诊所的所有1至18岁（平均：13.56±3.38）的性虐待受害者（n = 590）[男孩：83例（14.1%）；女孩：507例（85.9%）]。儿童与青少年精神病学及法医学专家对所有病例进行了评估。应用了韦氏儿童智力量表修订版（WISC - R）以及学龄儿童情感障碍与精神分裂症量表目前及终生版 - 土耳其语版（K - SADS - PL - T）。
75.2%的病例做出了与虐待相关的精神诊断（其中45.9%为重度抑郁症，31.7%为创伤后应激障碍病例）。在80.3%的病例中，受害者认识犯罪者[乱伦，n = 91例（15.1%）]，发生性交的占48.8%。尽管性别和年龄与任何精神障碍的出现无显著关联，但虐待的严重程度（如性交；p = 0.006）、额外的身体攻击（p < 0.001）和乱伦（p < 0.001）与精神障碍有显著相关性。为了探究多种因素对任何与性侵犯相关的精神障碍出现的预测价值，使用逻辑回归模型来确定年龄、性别、虐待严重程度、乱伦、是否有其他受害者、额外的身体攻击以及从首次受虐到首次精神评估的时间长度的最佳线性组合。这些变量的组合（乱伦的发生、额外的身体攻击以及从首次受虐到首次精神评估的时间较长）显著预测了任何类型精神障碍的出现（χ = 55.42；自由度 = 7；n = 522；p < 0.001）。
我们的研究结果表明，乱伦的发生、额外的身体攻击以及从首次受虐到首次精神评估的时间较长预示着与性虐待相关的精神障碍发生率较高。
