Citation

Sanci L, Coffey C, Olsson C, Reid S, Carlin JB, Patton G. Arch. Pediatr. Adolesc. Med. 2008; 162(3): 261-267.

Affiliation

Department of General Practice, University of Melbourne, 200 Berkeley St, Carlton, Victoria 3053, Australia. l.sanci@unimelb.edu.au

Copyright

(Copyright © 2008, American Medical Association)

DOI

10.1001/archpediatrics.2007.58

PMID

18316664

Abstract

OBJECTIVE: To examine the relationship between childhood sexual abuse (CSA) before the age of 16 years and later onset of bulimia and anorexia nervosa symptoms in females. DESIGN: A longitudinal cohort study of adolescents observed from August 1992 to March 2003. The cohort was defined in a 2-stage cluster sample using 44 Australian schools in Victoria. SETTING: Population based. PARTICIPANTS: A total of 1936 persons participated at least once and survived to the age of 24 years, including 999 females. The mean (SD) age of females at the start of follow-up was 14.91 (0.39) years; and at completion, 24.03 (0.55) years. Main Exposure Self-reported CSA before the age of 16 years was ascertained retrospectively at the age of 24 years. OUTCOME MEASURES: Incident Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)-defined partial syndromes of anorexia and bulimia nervosa were identified between waves 4 (mean age, 16.3 years) and 6 (mean age, 17.4 years) using the Branched Eating Disorder Test. RESULTS: The incidence of bulimic syndrome during adolescence was 2.5 (95% confidence interval, 0.80-8.0) times higher among those who reported 1 episode of CSA and 4.9 (95% confidence interval, 1.9-12.7) times higher among those who reported 2 or more episodes of CSA, compared with females reporting no episodes, adjusted for age and background factors. The association persisted after adjusting for possible confounders or mediators measured 6 months earlier, including psychiatric morbidity and dieting behavior. There was little evidence of an association between CSA and partial syndromes of incident anorexia nervosa. CONCLUSION: Childhood sexual abuse seems to be a risk factor for the development of bulimic syndromes, not necessarily mediated by psychiatric morbidity or severe dieting.

Language: en