Disordered eating as a repercussion of sexual assault: a consequence to consider.

PURPOSE: This study aims at clarifying the links between sexual violence and disordered eating (DE). METHODS: In a sample of 12,638 victims of self-reported sexual violence, we analyzed the situation of 546 victims that declared having developed DE. We assessed the characteristics of the assault (age, type of aggression) and the medical consequences (PTSD, depression, suicide attempts, anxiety disorders, etc.). RESULTS: DE prevalence was 4.3% in the victim sample. The age of the first assault in DE victims was significantly lower than that of the whole population (12 years vs 16 years for median; p < 0.001). A much higher prevalence of sexual assault consequences was present in victims developing DE with odd ratios (OR) for: self-mutilation (OR = 11.5 [8.29-15.95], p < 0.001); depression (OR = 5.7 [4.81-6.86], p < 0.001); self-medication (OR = 5.3 [3.86-7.19], p < 0.001); suicide attempts (OR = 4.5 [3.59-5.67], p < 0.001); post-traumatic stress disorder (OR = 3.8 [2.99-4.78], p < 0.001); anxiety troubles (OR = 5.2 [4.11-6.47], p < 0.001); alcoholism (OR = 4.0 [2.81-5.58], p < 0.001). CONCLUSION: This study confirms the link between DE and sexual violence, especially in childhood, leading to severe psychological consequences. In this context, DE should be envisaged as a coping strategy accompanying emotional dysregulation due to traumatic events, and be treated as such. LEVEL OF EVIDENCE: Level IV: Evidence obtained from multiple time series analysis such as case studies.

[Violence for educational purpose: Representations of general practitioners in the Paris area, France. A qualitative study]. / La violence éducative : représentations des médecins généralistes en Île-de-France. Étude qualitative.

BACKGROUND: Violence for educational purpose refers to a modality of education that includes threats, verbal abuse, physical abuse and humiliations. Twenty European countries, not including France, have abolished corporal punishment through explicit laws and regulations. The position of general practitioners in the screening and care of violence for educational purpose in France is unknown. In this study, we aimed to assess the representations of this form of violence among general practitioners. METHODS: We have performed semi-directed interviews of general practitioners in the Paris, France region (Île-de-France). Interviews were conducted until data saturation was achieved. Interviews were recorded, transcribed and analysed by two investigators. RESULTS: Interviews were conducted with 20 physicians (November 2015-January 2016). General practitioners considered that physical, verbal or psychological abuse had possible negative consequences on children. Uncertainty regarding the consequences of violence was a cause of tolerance towards violence for educational purpose, depending on the act committed and the context, as perceived by nearly all practitioners. General practitioners expressed interest in the field. They cited their own education and experience as the main obstacles to action. Most of them expressed a feeling of failure when they screened or took care of violence for educational purpose. CONCLUSION: This study suggests that doctors can participate in supporting the parents in the prevention of violence for educational purpose. Support to parents would need specific medical training as well as a societal change.

[Rape: a social problem and a public health issue]. / Le viol un problème de société, un problème de santé publique.

The French legal definition of rape was somewhat vague until the 1970s. In December 1980, the increased awareness created by the feminist movement led to a precise legal definition and to the possibility for self-help groups to participate in legal actions. In 1985, a telephone helpline was created after several rapes were following several rapes committed in public. Since 1986, more than 39 000 women have called this hotline. Other recent studies confirm the frequency of rape. Major advances have been made in recent years, in terms of justice for minors who are victims of rape (lengthening of the statutory limitation on sexual crimes) and healthcare provision (opening of refuges, medical-legal consultations, victim management centers, greater awareness among healthcare professionals, etc.). Women need to be better informed of the frequency of rape, its legal implications, rapists' strategies, mental disorders, and the physical (especially gynecological) repercussions of rape. Women must also be aware that the rapist is the only guilty party. Finally, a multidisciplinary strategy is needed, notably involving self-help associations and hospital units that deal with rape victims.