Child Sexual Abuse has a wide range of connotations. Psychiatric implications often include depression, post-traumatic stress disorder, and also self-harming behavior. Moreover it often determines personality correlates (in particular Borderline Personality Disorder).

In this contribution we report an explicative case of the consequences linked to child sexual abuse.

Patient: Male, 40 ys, divorced, one son (11 ys). He reports child sexual abuse by both parents (7 to 12 ys). Abuses ended when he fight with his father using a knife. He worked for an airline company, but was fired for an excess of work absence due to pathology. Since adolescence he presented obsessive-compulsive behavior, anxiety, mood instability, impulsiveness, flash backs, nightmares, attention difficulties and sleep disorder (linked to the idea of his own death during sleeping).

Clinical diagnoses: Post Traumatic Stress Disorder and Obsessive Compulsive Disorder (Axis I), and Personality Disorder NAS with obsessive compulsive and narcissistic traits (Axis II). He complains about side effects due to many drugs (different antidepressants, antipsychotics and mood stabilizers), but shows small responsiveness.

Test:

WAIS-R: I.Q.=105

RORCHACH: a personality organized with narcissistic defenses due to relational defects linked to self and identity definition.

SCID-II: Personality Disorder NAS with obsessive compulsive and narcissistic traits.