Female sexual victimization predicts psychosis: a case-control study based on the Danish Registry System

An increasing research literature has identified a statistical association between trauma exposure and psychosis. Methodological limitations, primarily relating to failures to establish the temporal ordering of events and relying on retrospective self-reports, have made the argument for a causal association difficult to establish.

A case-control study was conducted based on data from the Danish Civil Registration System and the Danish Psychiatric Central Register. All female visitors to a rape center during the index year (2003) were matched with controls based on age and area of residence. Information on previous and subsequent diagnoses of psychosis was extracted from the registers for cases and controls.

A hierarchical binary logistic regression was used with demographic variables, preindex psychosis, and rape center attendance as predictor variables, and the dependent variable was a postindex year diagnosis of psychosis. The OR associated with sexual victimization (OR = 10.04; 95% CI 2.50-40.33) indicted an increased likelihood of psychosis while controlling for the other predictors in the model.

This study found that sexual victimization significantly increased the likelihood of a diagnosis of psychosis and therefore suggests that there may be a role for traumatic experiences in the etiology of psychosis.