Psychiatric evaluation of sexual abuse cases: A clinical representative sample from Turkey

Abstract

Objective: This study investigated the characteristics of forensic childhood sexual abuse cases referred for psychiatric evaluation in a university hospital. Material and methods: The files of childhood sexual abuse cases referred from the Court to the Child and Adolescent Psychiatry Clinic between January 2006 and January 2010 were examined retrospectively. The information about demographic variables and characteristics of sexual abuse, as well as diagnostic and treatment processes was reviewed. Results: A total of 83 sexual abuse cases were evaluated. The majority of them (69%) were girls. The mean age of the children and adolescents was 11.01 +/- 3.9 years. The majority (73.5%) of the suspected perpetrators were familiar people, intrafamilial cases constituting 31.1%. The most common type of sexual abuse encountered was genital contact without penetration, representing 44.6% of the cases. All of the strangers were reported to legal authorities within 3 months whereas the ratio was 77% when offenders were familiar people (p<0.05). Forty percent of the cases involving family members as offenders needed additional evaluation by social services, in contrast to 11.3% of cases with offenders who were not family members (p<0.05). Anxiety Disorders and Adjustment Disorder were the most common psychiatric diagnoses. Family counseling for possible risk factors, child protection, and prevention of further abuse was provided for all cases. About 45% of the patients required additional medical treatment. Conclusion: The data, in many respects, share properties with western studies, such as greater number of girls, familiarity of the assaulters, delayed disclosure, increased need for social services especially for intrafamilial cases, and preponderance of anxiety disorders. Since abuse, whether sexual or physical, has a highly significant impact on the victim, publishing these data and emphasizing the topic of child sexual abuse should serve to facilitate recognition and management of such cases. (C) 2010 Elsevier Ltd. All rights reserved.