Child sexual abuse in women who take overdoses: I. A study of prevalence and severity

There is now considerable evidence that people reporting a history of child abuse have an increased prevalence of deliberate self-harm, a term that includes deliberate self-poisoning (overdose) and deliberate self-injury, but little information is available on the prevalence of abuse experiences in those who have harmed themselves. Modified versions of standardised self-report questionnaires of sexual, physical, and psychological abuse were administered to a sample of 257 female patients consecutively admitted over a one year period to a general hospital in England after taking an overdose. This study suggests that sexual abuse is very prevalent in the female overdose population. Seventy-two percent reported some form of sexual abuse, and 51% reported sexual abuse involving attempted or actual penetration. Grand repeaters (five overdoses or more) had been more severely abused for all three types of abuse. They were also more likely to have been sexually abused at a younger age (before age 13), for longer periods, and for the sexual abuse to have occurred again in adulthood. Our results support the view that childhood sexual abuse may place adults at special risk of subsequent overdoses or other deliberate self-injury. Therefore, clinicians should ask about abuse experiences during the routine psychiatric assessment following an overdose, and especially in those who harm themselves repeatedly.