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To review the literature on child sexual abuse with emphasis on psychosocial/psychodynamic aspects.
Systematic literature review from the articles indexed in Medline, PSYinfo, Pepsic, Lilacs and Scielo in the last ten years. Terms researched were: child sexual abuse, psychosocial, psychodynamic and psychoanalysis.
Child sexual abuse can have devastating consequences for the psychological functioning of children, possibly interfering with their proper process of development. It can contribute to violent behavior, acts of delinquency and mental disorders in adolescence and adulthood, as well as the development of comorbid post-traumatic stress and self-aggressive behaviors, risk behaviors and teenage pregnancy. Gravity of psychic consequences increase in relation to the frequency of abuse. Aspects of power, seduction and coercion are involved. Inequalities of age and gender are highlighted. Often practiced without the use of physical force, it may be difficult to be proven. A frequent abuser of familiarity with the child creates conditions that foster abuse. The revelation of the abuse may not occur, perpetuating the suffering and helplessness of the child. Sexually abused children may develop identification with the abuser and even become sexual offenders in adulthood. There are difficulties in the conceptual definition of abuse, the establishment of protocols for investigative and therapeutic management of cases and in predicting the immediate consequences along with the medium and long-term consequences.
Studies on the therapeutic practices used for the treatment of abused children and their families can help to construct therapeutic models, minimizing suffering in this terrible situation of violence.
To investigate socio-demographic and clinical trials of 19 sexually abused children.
Statistical analysis with SPSS of data on psychiatric and pediatric care of sexually abused children, aged 2-12 years old, treated at the Pediatric Service of University of Campinas-Brazil Clinical Hospital in 2007.
From a total of 19 children, 2 (10.5%) were boys and 17 (89.5%) girls. The average age group was 7.4 years. Eleven (57.9%) attended regular school, one (5.3%) attended special school, one (5.3%) pre-school and six (31.5%) did not attend any school. Regarding ethnicity, 11 (57.9%) children were white and eight (42.1%) non-white. The abuse was committed with physical threats in nine (47.4%) cases, without threats in two (10.5%). Eight children were unable to define physical threat. The abuse occurred only once in 10 (52.6%) cases and several times in nine (47.4%). Prior psychiatric treatment occurred in two (5.3%) children and psychological treatment in six (31.6%). Twelve (63.2%) children had never attended psychological or psychiatric consultations. Eleven (57.9%) children received a psychiatric diagnosis and referral for treatment. In 13 (68.4%) attendance was diagnosed in the Z-code of the International Classification of Diseases-10. Family and people close to children appear as abusers in 15 cases (78.9%).
Despite the small sample, this study supports the literature in which child sexual abuse appears as a phenomenon more frequent in girls, dysfunctional families, and practiced mainly by family members or close friends of children. The relationship with psychiatric disorders was also highlighted.
The HCV has been associated with significant impairment of quality of life, irrespective of the degree of liver injury. The association of this disease with psychiatric comorbidities, especially depression, has been well described in the scientific literature. However, despite also significantly affect the quality of life of individuals, the Posttraumatic Stress Disorder (PTSD) has not been well studied in this population.
Evaluate whether individuals perceive the liver disease as a potentially traumatic experience and investigate the impact of PTSD diagnosis on health-related quality of life in hepatitis C virus-infected subjects.
We conducted a cross-sectional survey of 127 consecutive hepatitis C-infected outpatients. We investigated Traumatic Experiences and the subject's perception about the disease using the Trauma History Questionnaire. PTSD and others psychiatry diagnoses were assessed trough M.I.N.I. PLUS. Quality of life was assessed by the Short-Form 36.
Approximately 38.6% of the patients perceived the hepatitis C as a traumatic experience, 60.7% had PTSD diagnosis. It were no associate with the disease severity (been eligible for transplant), however there was a significant association with diagnosis of PTSD (p = 0.003). Roughly 22% of the sample showed PTSD diagnosis. PTSD imposed a significant impairment in quality of life of individuals in seven of the eight domains in the bivariate and multivariate analysis. This difference remained significant after adjustment for covariates such as major depressive disorder comorbidity.
The results suggest high prevalence of PTSD diagnosis in VHC infected patients and it impose impairment in their quality of life.
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