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Am J Psychiatry 1991; 148:55-61
Copyright © 1991 by American Psychiatric Association
Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse
GR Brown and B Anderson
Department of Psychiatry, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Tex.
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.
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