Abstract
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.
Highlights
MethodsSexual abuse is a crime with a high prevalence all over the world, with often devastating health consequences
Looking further into the data, we found that the incidence of recorded diagnoses of depression and anxiety among the girls with a child sexual abuse (CSA) experience registration increased by approximately 150% during the same period, indicating that the decrease in odds ratios (ORs) for the girls with a CSA experience registration is more likely to reflect a general increase of depression and anxiety among adolescent girls as they grow older, than a decrease of symptoms among the girls with a CSA experience registration
The contacts and medication offered to adolescent girls in the Stockholm Region, Sweden, after their first registered CSA experience, seem not to be sufficient to prevent an increase of suicidal attempts during the following year, nor does it prevent the development of eating disorders and borderline personality disorders (BPD) in the aftermath of CSA
Summary
MethodsSexual abuse is a crime with a high prevalence all over the world, with often devastating health consequences. In 2019, we presented a second study using the register-based health care data from the Stockholm Region. In this case–control study, we analyzed the healthcare consumption patterns of the sexually abused adolescent girls, 2 and 1 years prior to their first registered CSA experience, and compared them to matched controls [19]. The health care consumption among the girls with a registered CSA experience was drastically higher, and differed remarkably from their matched controls. The aim of this study was to follow the same cohort and analyze how their healthcare consumption levels and patterns developed, including whether there were different developmental trajectories regarding the various diagnoses, 1 and 2 years after the first registered CSA experience.
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