RESUMO
In light of recent studies indicating a relationship between child abuse and the positive symptoms of schizophrenia, this study investigated the hypotheses that childhood sexual and physical abuse are related to hallucinations, delusions, and thought disorder in adults, and that those relationships are greater in those who have suffered abuse during adulthood as well as childhood. In 200 community mental-health-centre clients, the clinically evaluated symptomatology of the 92 clients whose files documented sexual or physical abuse at some point in their lives was compared with that of the 108 for whom no abuse was documented. In the 60 patients for whom child abuse was documented, hallucinations (including all six subtypes), but not delusions, thought disorder or negative symptoms, were significantly more common than in the non-abused group. Adult sexual assault was related to hallucinations, delusions, and thought disorder. In linear regression analysis, a combination of child abuse and adult abuse predicted hallucinations, delusions, and thought disorder. However, child abuse was a significant predictor of auditory and tactile hallucinations, even in the absence of adult abuse. Possible psychological and neurobiological pathways from abuse to symptoms are discussed, along with research and clinical implications.
Assuntos
Abuso Sexual na Infância/psicologia , Maus-Tratos Infantis/psicologia , Transtornos Cognitivos/etiologia , Delusões/etiologia , Alucinações/etiologia , Pensamento , Adolescente , Adulto , Idoso , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Abuso Sexual na Infância/estatística & dados numéricos , Pré-Escolar , Transtornos Cognitivos/epidemiologia , Delusões/epidemiologia , Feminino , Previsões , Alucinações/epidemiologia , Humanos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Prevalência , Análise de Regressão , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologiaRESUMO
The files of 200 users of a community mental health centre revealed that 46% of the files contained documentation of sexual or physical abuse as children or adults. Only 36% of summary formulations and 33% of treatment plans for the abused clients mentioned the abuse. Only 22% of the abused clients received abuse-focused therapy. Response rates were lower for clients who were male or had a schizophrenia spectrum diagnosis, and if the clinician was male or a psychiatrist. None of the alleged crimes, past, recent or ongoing, was reported to legal authorities. Development of unit policies and training programmes to ensure appropriate response to abuse histories is recommended.
