Psychiatric Assessment and Follow-Up of Child Abuse Victims: Experience From the Last Four-Years

Objective:

To determine the psychiatric diagnoses and follow up status of children and adolescents who were referred to a child and adolescent psychiatry outpatient unit due to sexual abuse.

Method:

Data from chart records of 144 children and adolescents who were referred to Ankara University, Department of Child and Adolescent Psychiatry for suspected child abuse between the years 2008 and 2011 were retrospectively evaluated. Additional 118 cases that were evaluated in collaboration with Ankara Child Protection Unit were not included in this study. Psychiatric diagnoses of child sexual abuse victims and their follow up and post-assessment outcomes were determined according to their chart records.

Results:

The analysis included sexually abused child and adolescent objects only. The mean age at the time of referral was 12.7±3.4 years (3-18), and 35 (24.3%) victims were boys while 109 (75.7%) were girls. According to DSM-IV criteria, 132 (91.7%) cases were diagnosed with a psychiatric disorder at the time of psychiatric assessment interview. Twelve patients (8.3%) had developed emotional and behavioral problems after sexual abuse even though they were not severe enough to meet a psychiatric diagnosis (anxiety, feelings of guilt, sleep disturbances, etc). It was detected that 74 (51.4%) patients did not come to follow up visit after their fi rst assessments. We ascertained that the percentage of patients who had made irregular visits was 18.8% (n=27) and only 29.9% (n=43) of the patients had regularly attended

Discussion:

In this study, it was indicated that emergence of psychiatric and behavioral problems in child sexual abuse victims is a rule rather than exception. On the other hand, the rate of attendance to psychiatric follow up visits was rather low. Therefore, forensic process should not focus solely on the question of “Whether mental health was impaired after the sexual abuse or not”, Instead, for the best interest of the child and the family, making physical regulations which shall provide regular access to mental health services and converting the process into a type of health precaution practice might be considered.