Clinical characteristics of children presenting with history of sexual abuse to a tertiary care centre in India

• A retrospective chart review of 40 children with history of CSA was performed.
• Psychiatric morbidity was high in these children.
• Multiple instances of abuse were related to psychiatric problems.
• Abuse by multiple perpetrators related to depression and sexualized behaviour.
• Engagement with caregivers and flexible, focused and time limited interventions are vital.

ObjectivesTo study the clinical features of children with history of sexual abuse.MethodA chart review of 40 children (<16 years) with history of Child Sexual Abuse (CSA) evaluated at the Department of Child and Adolescent Psychiatry at NIMHANS during a three year period.Results52.5% (N = 21) of the children came from broken families. The most common form of abuse was contact penetrative (67.5%) followed by contact non-penetrative abuse (30%). Seventy-Five percent (N = 30) had a psychiatric diagnosis at baseline and 37.5% of these children had comorbidities. The commonest diagnoses were Depressive Disorder (35%) followed by Stress related disorders – PTSD and Acute Stress Disorder (25%). Children abused multiple times were more likely to have psychiatric illness following CSA. Children abused by multiple perpetrators were more likely to have depression, psychiatric comorbidity and more prone to exhibit sexualized behaviour. Sixty five percent of children did not follow up 8 weeks after the initial consultation.DiscussionPsychiatric morbidity is high in the population of children with history of CSA. It is necessary to assess the risk factors, circumstances of abuse along with psychiatric morbidity in order provide flexible and tailor made interventions for this population. In order to ensure the best possible care for these families, focused and time limited intervention that respect the needs of the child and addresses the ground realities of the circumstances of the family and the health system are the need of the day.