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Objectives: Child sexual abuse (CSA) is defined “as the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared, or else that violates the laws or social taboos of society. Children can be sexually abused by both adults and other children who are by virtue of their age or stage of development in a position of responsibility, trust or power over the victim”. The prevalence of CSA is alarmingly high. Statistical data in USA indicate that 10–34% of all girls and 3–18% of all boys are subjected to sexual abuse before the age of 18. In a study carried out in Turkey on female high school students, it was reported that 13.4% of girls are exposed to sexual abuse. CSA has received considerable attention since the late 1970’s from medical, mental health, legislative, judicial, and law enforcement professionals, as well as the media and lay public, making it the most researched form of child maltreatment. This is due to clinical and research findings that indicate considerable short and long-term consequences of CSA on mental and physical health. The aim of this study is to investigate the sexually abused cases, which are directed to our polyclinic by the judicial authorities in order to regulate the reports.
Methods: We investigated for this study, 58 cases between ages of 8–17, who were exposed to sexual abuse and, for the preparation of a forensic medicine report. The investigators retrospectively examined case files, social services investigation reports and forensic reports. Sociodemographic characteristics of the cases, the diagnosis of psychiatric disorder were evaluated by keeping a separate record for each case.
Results: Overall 58 cases between the ages of 8–17 (14.59±1.93), 54 of whom are girls (93.1%) and four of whom are boys (6.9%) were included in the study. Psychiatric diagnoses which were determined in cases that were sexually abused are post-traumatic stress disorder (10.3%), acute stress disorder (19.0%) and depressive disorders (25.9%). 55.2% (n=32) of victims displayed at least one Axis I psychopathology. In 10.3% (n=6) of the cases comorbid psychiatric disorder was present. The level of intelligence was rated as normal in 82.8% of the cases and mental retardation in 17.8% of the cases was recorded.
Conclusions: In various studies, it was observed that depressive and anxiety disorders were the most frequent psychiatric disorders in child and adolescents exposed to sexual abuse. In the present study, consistent with the literature, psychiatric disorders were found in 55.2% of victims, with depressive and anxiety disorders being the most frequent diagnoses. Our results emphasize need of comprehensive screening, assessment and treatment of mental disorders for those children and adolescents who were exposed to sexual abuse. It is important to educate all child and adolescents about sexual abuse and to make special centers for them to report the abuse