Division for Family and Community Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 12, 141 83, Huddinge, Sweden.
Academic Primary Healthcare Centre, Stockholm, Sweden.
Eur Child Adolesc Psychiatry. 2021 Nov;30(11):1803-1811. doi: 10.1007/s00787-020-01670-w. Epub 2020 Nov 1.
Child sexual abuse (CSA) is a crime against human rights with severe health consequences, and suicidal actions, stress, eating disorders, and borderline disorder are common among survivors of CSA. The objective of this study was to analyze how health care consumption patterns developed among adolescent girls in the Stockholm Region, Sweden, 1 and 2 years after the first registration of CSA experience appeared in their medical record, as compared to age-matched controls without such registration. In this cohort study, number of healthcare visits, comorbidities, and prescribed drugs were collected through the Stockholm Region administrative database (VAL), for girls age 12-17 with registration of CSA experience in their medical record (n = 519) and age-matched controls (n = 4920) between 2011 and 2018. Healthcare consumption patterns remained higher among the girls with a registered CSA experience compared to the controls, both 1 and 2 years after the first CSA experience registration. Highest odds ratios (ORs) were found for suicide attempts [OR 26.38 (12.65-55.02) and 6.93 (3.48-13.49)]; stress disorders [25.97 (17.42-38.69) and 15.63 (9.82-24.88)]; psychosis [OR 19.39 (1.75-214.13) and 9.70 (1.36-68.95)], and alcohol abuse [OR 10.32 (6.48-16.44) and 6.09 (1.98-18.67)], 1 and 2 years, respectively, after the first CSA experience registration. The drug prescriptions were also significantly higher among the girls with a CSA experience registration than for the controls. The results highlight the need to systematically evaluate and develop assessment, treatment planning, and interventions offered to adolescent girls after their first CSA experience registration.
儿童性虐待（CSA）是一种侵犯人权的犯罪行为，会导致严重的健康后果，而自杀行为、压力、饮食失调和边缘性障碍是 CSA 幸存者中常见的问题。本研究的目的是分析瑞典斯德哥尔摩地区的少女在首次出现 CSA 经历的医疗记录后 1 年和 2 年的医疗保健消费模式，与没有此类记录的年龄匹配对照组相比。在这项队列研究中，通过斯德哥尔摩地区行政数据库（VAL）收集了少女的医疗记录中 CSA 经历的首次登记（n=519）和年龄匹配对照组（n=4920）的就诊次数、合并症和处方药物。与对照组相比，在 CSA 经历首次登记后 1 年和 2 年，有登记 CSA 经历的少女的医疗保健消费模式仍然较高。自杀未遂的比值比（OR）最高[OR 26.38（12.65-55.02）和 6.93（3.48-13.49）]；应激障碍[25.97（17.42-38.69）和 15.63（9.82-24.88）]；精神病[OR 19.39（1.75-214.13）和 9.70（1.36-68.95）]和酒精滥用[OR 10.32（6.48-16.44）和 6.09（1.98-18.67）]，分别为 CSA 首次登记后 1 年和 2 年。CSA 经历登记组的药物处方也明显高于对照组。研究结果强调需要系统地评估和制定评估、治疗计划和干预措施，为首次 CSA 经历登记后的少女提供。
