Child sexual abuse - a predictor of persistent depression in adult rape and sexual assault victims

Abstract

Objective: To examine the association between adult rape and sexual assault and persistent depression. Design: A two stage case detection and case identification design, using the 30-item General Health Questionnaire and the Beck Depression Inventory for screening and the affective items relating to current functioning on the Schizophrenia and Affective Disorders Schedule to identify depressed cases. Details of sexual abuse were elicited retrospectively by semi-structured interview. Details of sexual abuse were gathered from childhood and from adult life. Setting: Three general practices in middle class suburban, deprived inner city, and rural areas. Subjects: One thousand, one hundred and eighty-nine women were screened and 237 subsequently interviewed; 132 were depressed. Results: Thirty-five (15 %) of the interviewees had been sexually assaulted or raped in adult life. Seventy-three (31 %) reported experience of child sexual abuse involving contact. Adult rape and sexual assault were not related to depression unless there had also been prior child sexual abuse. Conclusion: Child sexual abuse is a predictor of persistent depression in women who are sexually assaulted or raped in adult life.