@article{ref1,
title="Sexual abuse and its impact on suicidal ideation and attempts and psychiatric illness in children and adolescents with posttraumatic stress disorder",
journal="Primary care companion to CNS disorders",
year="2023",
author="Mainali, Pranita and Motiwala, Fatima and Trivedi, Chintan and Vadukapuram, Ramu and Mansuri, Zeeshan and Jain, Shailesh",
volume="25",
number="1",
pages="22m03239-22m03239",
abstract="OBJECTIVE: Sexual abuse in minors aged 6-17 years is a significant public health concern. Victims of sexual abuse are at risk of developing complex psychopathology and chronic suicidal thoughts. Posttraumatic stress disorder (PTSD) develops in one-third of minors with a history of sexual abuse. The primary objective of this study was to assess the baseline characteristics of minors with PTSD and a history of sexual abuse (PTSD+S) compared with minors with PTSD without sexual abuse (PTSD only). The secondary objective was to evaluate the psychiatric comorbidities and suicidal ideation/attempts between the groups. <br><br>METHODS: The National Inpatient Sample database from 2006 to 2014 was analyzed using the ICD-9 code for PTSD and history of sexual abuse. PTSD+S (n = 251) subjects were compared with those with PTSD only (n = 24,243) using t test and χ(2) test. Univariate and multivariate logistic regression analyses were performed with suicidal behavior (suicidal ideation/attempt) as the outcome and PTSD with and without sexual abuse, sex, age, and other psychiatric comorbid conditions as independent variables. <br><br>RESULTS: More patients in the PTSD+S group were nonwhite (52% vs 42%, P < .001) and female (81% vs 66%, P < .001) compared to PTSD only patients. Also, more patients were Hispanic in the PTSD+S group compared to the PTSD only group (28% vs 13%). Major depressive disorder (MDD; 23% vs 14%, P < .001) and substance use disorder (SUD; 20% vs 11%) were more commonly diagnosed psychiatric comorbidities in the PTSD+S group (P < .001). Suicidal behavior (suicidal ideation/attempt) was higher in the PTSD+S group than in PTSD only patients (36% vs 30%, P = .05). Overall, the risk of suicidal behavior was 29% higher in the PTSD+S group than in PTSD only patients (odds ratio [OR] = 1.29, P = .05). In the multivariate analysis, after controlling for age and sex, comorbid diagnosis of MDD (OR = 1.66, P < .001) and SUD (OR = 1.18, P < .001) was associated with increased suicidal behavior. However, PTSD+S showed no association with suicidality (OR = 1.16, P = .29) in the multivariate analysis. <br><br>CONCLUSIONS: Sexual abuse is associated with PTSD and higher risk of comorbid psychiatric illnesses, including MDD, SUD, and suicidal behavior. In-depth research on the relationship between child and adolescent sexual abuse and chronic suicidality is warranted.<p /> <p>Language: en</p>",
language="en",
issn="2155-7772",
doi="10.4088/PCC.22m03239",
url="http://dx.doi.org/10.4088/PCC.22m03239"
}