Department of Neurobiology, Care Sciences and Society, Division for Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden.
Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.
Nord J Psychiatry. 2021 Jul;75(5):370-377. doi: 10.1080/08039488.2020.1868573. Epub 2021 Jan 11.
Sexual abuse is associated with severe health consequences, and the European Union has, through the Istanbul Convention, urged its member countries to provide specialist care for victims of sexual abuse.
This aim of this study was to investigate patient- and abuse-related characteristics among patients seeking help at a specialist clinic in Sweden, with focus on disclosure, mental health and appropriate healthcare access.
This is a descriptive study where journal data from 100 consecutive patients January 2017 to February 2018 were analyzed. All adult individuals (women = 80, men = 8) who had taken part in the standardized semi-structured intake interview at the clinic were included ( = 88).
At admission, mean age was 40.3 (SD 11.9), mean number of psychiatric diagnoses 6.3 (2.6), and 93% of the patients scored above cut-off (≥34) on IES-R for PTSD. A majority of the patients (87%) had been exposed to childhood sexual abuse (CSA), and mean time to first disclosure was 15.9 (SD 15.3) years. In total, 82% of the patients had, despite disclosure, experienced difficulties accessing appropriate healthcare before coming to the specialist clinic.
Adult victims of sexual abuse have difficulties accessing appropriate healthcare. This constitutes a gender-based equality problem. A model of gatekeeping mechanisms with two dimensions ( and ) and three categories ( and ) is proposed to understand these difficulties.
性虐待会导致严重的健康后果，欧盟通过《伊斯坦布尔公约》敦促其成员国为性虐待受害者提供专业护理。
本研究旨在调查在瑞典一家专科诊所寻求帮助的患者的患者和虐待相关特征，重点是披露、心理健康和适当的医疗保健途径。
这是一项描述性研究，分析了 2017 年 1 月至 2018 年 2 月期间在诊所接受标准化半结构化摄入访谈的 100 名连续患者的期刊数据。所有成年患者（女性 80 人，男性 8 人）均纳入研究（n=88）。
入院时，平均年龄为 40.3（SD 11.9），平均精神诊断数为 6.3（2.6），93%的患者 PTSD 症状严重程度量表（IES-R）得分高于临界值（≥34）。大多数患者（87%）曾遭受过儿童期性虐待（CSA），首次披露的平均时间为 15.9（SD 15.3）年。尽管有披露，但在来专科诊所之前，82%的患者在获得适当的医疗保健方面遇到了困难。
性虐待的成年受害者在获得适当的医疗保健方面存在困难。这构成了一个基于性别的平等问题。提出了一个包含两个维度（和）和三个类别的把关机制模型（和），以理解这些困难。
