Child abuse and severity of disturbance among adult psychiatric inpatients

The aim of this study was to determine whether childhood abuse is related to severity of psychological disturbance in adulthood, even within an extremely disturbed, predominantly psychotic, population.

The medical records of 100 consecutive admissions to an adult psychiatric inpatient unit were examined. Documentation of physical or sexual abuse as a child was recorded together with several measures of severity of pathology including: suicidality, length of current admission, age at first admission and use of Intensive Care Unit and Mental Health Act.

The study revealed relationships between childhood sexual or physical abuse and suicidality, duration of hospitalization, and age at first admission. Several gender differences in these relationships were found. These included the finding that sexually abused males, but not sexually abused females, were significantly more suicidal than their nonabused counterparts.

The theoretical and clinical implications of further evidence that child abuse is related to the most severe levels of dysfunction in adulthood, including psychosis, are discussed. The need for routine child abuse inquiry in inpatient settings is reiterated.