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

• Published in: European child & adolescent psychiatry 2021-11, Vol.30 (11), p.1803-1811
• Main Authors: Rajan, Gita, Syding, Sanna, Ljunggren, Gunnar, Wändell, Per, Wahlström, Lars, Philips, Björn, Svedin, Carl Göran, Carlsson, Axel C.
• Format: Article
• Language: English
• Subjects: Administrative databases; Adolescent; Adolescent girls; Age; Alcohol abuse; Child; Child & adolescent psychiatry; Child abuse & neglect; Child Abuse, Sexual - psychology; Child Abuse, Sexual - statistics & numerical data; Child and Adolescent Psychiatry; Child sexual abuse; Children; Cohort analysis; Cohort Studies; Comorbidity; Consumption; Consumption patterns; Crime; Disorders; Drug abuse; Drugs; Eating disorders; Epidemiology; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Girls; Health care; Health services; Human rights; Humans; Hälsovetenskap; Klinisk medicin; Medical diagnosis; Medical records; Medication; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Mental Disorders - diagnosis; Original Contribution; Patient Acceptance of Health Care - statistics & numerical data; Pedophilia; Prescription drugs; Psychiatry; Psychology; Psychosis; Psykiatri; psykologi; Regions; Registration; Sex crimes; Sexual abuse; Social disorganization; Stress; Substance abuse; Suicide; Suicides & suicide attempts; Sweden
• ISSN: 1018-8827; 1435-165X; 1435-165X
• DOI: 10.1007/s00787-020-01670-w

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.