OBJECTIVE: To extend the knowledge on long-term effects of childhood
abuse in psychiatric patients to a large sample, the authors explored
childhood sexual and physical abuse in adult inpatients over 1,040
consecutive admissions. METHOD: The 947 patients were admitted to a
tertiary-care military medical center. Each patient was interviewed, and
abuse history, DSM-III-R diagnosis, and other characteristics were
recorded. RESULTS: The prevalence of reported childhood abuse was 18%
overall: 9% for sexual abuse (with or without physical abuse), 10% for
physical abuse (with or without sexual abuse), and 3% for combined abuse.
More female than male patients reported abuse. Alcohol use disorders were
more common in victims of physical or combined abuse than in sexually
abused or nonabused patients. Axis II diagnoses, particularly borderline
personality disorder, were more frequent in abuse victims than in nonabused
patients. Histories of drug and alcohol abuse were more common in patients
reporting physical or combined abuse than in nonabused patients.
Suicidality was also more frequent in abused than nonabused inpatients and
was noted in 79% of the patients with histories of combined abuse. Combined
abuse in women and physical abuse in men were associated with a family
history of psychiatric illness, most commonly alcoholism in male relatives.
CONCLUSIONS: These findings emphasize the need for greater attention to
family dynamics, aggressive diagnosis and treatment of alcoholism within
the family, and, especially, determination of patients' abuse histories,
even if repeated questioning is necessary.