OBJECTIVE: To extend the knowledge on long-term effects of
childhood abuse in psychiatric patients to a large sample, the authors
explored childhood sexual and physical abuse in adult inpatients over
1,040 consecutive admissions. METHOD: The 947 patients were admitted
to a tertiary-care military medical center. Each patient was
interviewed, and abuse history, DSM-III-R diagnosis, and other
characteristics were recorded. RESULTS: The prevalence of reported
childhood abuse was 18% overall: 9% for sexual abuse (with or without
physical abuse), 10% for physical abuse (with or without sexual
abuse), and 3% for combined abuse. More female than male patients
reported abuse. Alcohol use disorders were more common in victims of
physical or combined abuse than in sexually abused or nonabused
patients. Axis II diagnoses, particularly borderline personality
disorder, were more frequent in abuse victims than in nonabused
patients. Histories of drug and alcohol abuse were more common in
patients reporting physical or combined abuse than in nonabused
patients. Suicidality was also more frequent in abused than nonabused
inpatients and was noted in 79% of the patients with histories of
combined abuse. Combined abuse in women and physical abuse in men were
associated with a family history of psychiatric illness, most commonly
alcoholism in male relatives. CONCLUSIONS: These findings emphasize
the need for greater attention to family dynamics, aggressive
diagnosis and treatment of alcoholism within the family, and,
especially, determination of patients' abuse histories, even if
repeated questioning is necessary.