Diagnoses of sexual abuse and their common registered comorbidities in the total population of Stockholm

Rajan, Gita; Ljunggren, Gunnar; Wändell, Per; Wahlström, Lars; Svedin, Carl Göran; Carlsson, Axel C.

doi:10.1136/jech-2016-208105

Cited by 14 publications

(17 citation statements)

References 46 publications

(24 reference statements)

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“…New technique and electronic journal records have opened up new possibilities for analyzing healthcare data. In 2017, we replicated prior results, and quantified with real numbers by a register-based study including over 2 million persons in Stockholm Region, Sweden [17]. The odds for stress-related diagnoses and depression were tenfold higher among those with a sexual abuse (SA) experience registration, compared to those without SA experience registration [17].…”

Section: Introductionsupporting

confidence: 57%

“…In 2017, we replicated prior results, and quantified with real numbers by a register-based study including over 2 million persons in Stockholm Region, Sweden [ 17 ]. The odds for stress-related diagnoses and depression were tenfold higher among those with a sexual abuse (SA) experience registration, compared to those without SA experience registration [ 17 ]. However, in that study, the comorbidities and the registered SA experience were collected in the same time frame.…”

Section: Introductionmentioning

confidence: 54%

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Health care consumption and psychiatric diagnoses among adolescent girls 1 and 2 years after a first-time registered child sexual abuse experience: a cohort study in the Stockholm Region

Rajan

Syding

Ljunggren

et al. 2020

Eur Child Adolesc Psychiatry

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Child sexual abuse (CSA) is a crime against human rights with severe health consequences, and suicidal actions, stress, eating disorders, and borderline disorder are common among survivors of CSA. The objective of this study was to analyze how health care consumption patterns developed among adolescent girls in the Stockholm Region, Sweden, 1 and 2 years after the first registration of CSA experience appeared in their medical record, as compared to age-matched controls without such registration. In this cohort study, number of healthcare visits, comorbidities, and prescribed drugs were collected through the Stockholm Region administrative database (VAL), for girls age 12–17 with registration of CSA experience in their medical record (n = 519) and age-matched controls (n = 4920) between 2011 and 2018. Healthcare consumption patterns remained higher among the girls with a registered CSA experience compared to the controls, both 1 and 2 years after the first CSA experience registration. Highest odds ratios (ORs) were found for suicide attempts [OR 26.38 (12.65–55.02) and 6.93 (3.48–13.49)]; stress disorders [25.97 (17.42–38.69) and 15.63 (9.82–24.88)]; psychosis [OR 19.39 (1.75–214.13) and 9.70 (1.36–68.95)], and alcohol abuse [OR 10.32 (6.48–16.44) and 6.09 (1.98–18.67)], 1 and 2 years, respectively, after the first CSA experience registration. The drug prescriptions were also significantly higher among the girls with a CSA experience registration than for the controls. The results highlight the need to systematically evaluate and develop assessment, treatment planning, and interventions offered to adolescent girls after their first CSA experience registration.

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Section: Introductionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 54%

Health care consumption and psychiatric diagnoses among adolescent girls 1 and 2 years after a first-time registered child sexual abuse experience: a cohort study in the Stockholm Region

Rajan

Syding

Ljunggren

et al. 2020

Eur Child Adolesc Psychiatry

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“…The high risk of re-victimization after CSA in combination with delayed disclosure, also makes it plausible that some of the cases with their first diagnosis of sexual abuse registered at Södersjukhuset in Stockholm had experiences of CSA prior to the sexual abuse that resulted in the visit to the clinic. This assumption is also supported by research that has shown a 25% higher amount of reports on sexual assaults to the police, than diagnoses of sexual abuse recorded within the health care system, for the same population during the same period of time [ 28 ].…”

Section: Discussionmentioning

confidence: 77%

“…However, in 2017 we presented a register-based study including over two million persons in Stockholm replicating prior results, and also quantifying the results with real numbers and their relative magnitude in comparison with the general population in the Stockholm Region, Sweden. In this study, adolescent girls represented more than half of all cases, and the odds for stress-related diagnoses and depression were tenfolds higher among these girls than in those without a diagnosis of sexual abuse [28]. A limitation to this study was that the co-morbidities and the registered diagnoses of sexual abuse were collected in the same time frame.…”

Section: Introductionmentioning

confidence: 89%

Health care consumption among adolescent girls prior to diagnoses of sexual abuse, a case–control study in the Stockholm Region

Rajan

Ljunggren

Wändell

et al. 2019

Eur Child Adolesc Psychiatry

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Victims of sexual abuse have more co-morbidities than other persons in the same age and the most affected group are adolescent girls. Little is known about how this is reflected in health care consumption patterns prior to the registered diagnosis. The aim of this investigation was to study health care consumption patterns among girls, 12-17 years old, 1 and 2 years prior to their diagnoses of sexual abuse. Through the Stockholm Region administrative database (VAL), data of co-morbidities, number of health care visits, and prescribed drugs were collected for cases (girls age 12-17 with diagnoses of sexual abuse, n = 519) and controls matched for age and socioeconomic status (n = 4920) between 2011-2018. Health care consumption and co-morbidities were significantly higher for the cases compared to controls, with a rise 1 year before the diagnoses: the total number of health care visits (including no shows) 1 year prior to the first recording of the diagnosis was 20.4 (18.1-22.7) for the cases and 6.2 (5.8-6.6) for the controls. The most frequent visits 1 year prior to the diagnosis were to outdoor clinics, with a mean value of 19.1 (16.9-21.3) visits for the cases and 5.7 (5.3-6.1) for the controls, followed by psychiatric clinics with a mean value of 12.7 (10.6-14.8) visits for the cases and 2.0 (1.7-2.3) visits for the controls. The least visited health care clinic 1 year prior to the diagnosis was the emergency ward with a mean value of 1.3 (1.1-1.5) visits for the cases and 0.5 (0.4-0.5) visits for the controls. The most common psychiatric co-morbidities registered among the cases during the first year before the diagnosis of sexual abuse were stress, suicide attempt, and psychosis. Neuroleptics, sleeping pills, antidepressants, and tranquilizers were more frequently dispensed in cases than in controls. Similar patterns were found 2 years prior to the diagnosis. We encourage clinicians to actively ask for exposure of sexual abuse in girls with high health care consumption, making early detection and treatment of sexual abuse available as soon as possible.

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“…Implicit in this language is the assumption that survivors of sexual violence are always female. Although statistics show that females are more likely to be victimised (Asgeirsdottir et al, 2011;Rajan et al, 2017), male survivors do exist, and they are somewhat excluded from this community of survivors. The digital aspect may also exclude older adults.…”

Section: Discussionmentioning

confidence: 99%

Rape in the Nordic Countries

Heinskou¹,

Skilbrei²,

Stefansen³

2019

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Diagnoses of sexual abuse and their common registered comorbidities in the total population of Stockholm

Abstract: Diagnoses of drug and alcohol abuse, psychotic, bipolar, stress anxiety disorders, depression and somatic pain are more common among individuals with a diagnosis of sexual abuse than among individuals without a diagnosis of sexual abuse.

Cited by 14 publications

References 46 publications

Health care consumption and psychiatric diagnoses among adolescent girls 1 and 2 years after a first-time registered child sexual abuse experience: a cohort study in the Stockholm Region

Health care consumption and psychiatric diagnoses among adolescent girls 1 and 2 years after a first-time registered child sexual abuse experience: a cohort study in the Stockholm Region

Health care consumption among adolescent girls prior to diagnoses of sexual abuse, a case–control study in the Stockholm Region

Rape in the Nordic Countries

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