Long-term outcomes of childhood sexual abuse: an umbrella review

This study is registered with PROSPERO, CRD42016049701.FindingsWe identified 19 meta-analyses that included 559 primary studies, covering 28 outcomes in 4 089 547 participants. Childhood sexual abuse was associated with 26 of 28 specific outcomes: specifically, six of eight adult psychiatric diagnoses (ORs ranged from 2·2 [95% CI 1·8–2·8] to 3·3 [2·2–4·8]), all studied negative psychosocial outcomes (ORs ranged from 1·2 [1·1–1·4] to 3·4 [2·3–4·8]), and all physical health conditions (ORs ranged from 1·4 [1·3–1·6] to 1·9 [1·4–2·8]). Strongest psychiatric associations with childhood sexual abuse were reported for conversion disorder (OR 3·3 [95% CI 2·2–4·8]), borderline personality disorder (2·9 [2·5–3·3]), anxiety (2·7 [2·5–2·8]), and depression (2·7 [2·4–3·0]). The systematic reviews for two psychiatric outcomes (post-traumatic stress disorder and schizophrenia) and one psychosocial outcome (substance misuse) met high quality standards. Quality was low for meta-analyses on borderline personality disorder and anxiety, and moderate for conversion disorder. Assuming causality, population attributable risk fractions for outcomes ranged from 1·7% (95% CI 0·7–3·3) for unprotected sexual intercourse to 14·4% (8·8–19·9) for conversion disorder.InterpretationAlthough childhood sexual abuse was associated with a wide range of psychosocial and health outcomes, systematic reviews on only two psychiatric disorders (post-traum...
Source: The Lancet Psychiatry - Category: Psychiatry Source Type: research