Disclosure of sexual abuse by adolescents treated in a psychiatry department

Emilie Carretier; Marine Jourdan; Sophie Duchesne; Julien Flouriot; Jonathan Lachal; Marie-Rose Moro

doi:10.1016/j.encep.2023.12.003

Disclosure of sexual abuse by adolescents treated in a psychiatry department

Encephale. 2024 Mar 23:S0013-7006(24)00043-5. doi: 10.1016/j.encep.2023.12.003. Online ahead of print.

Authors

Emilie Carretier¹, Marine Jourdan², Sophie Duchesne³, Julien Flouriot⁴, Jonathan Lachal⁵, Marie-Rose Moro⁶

Affiliations

¹ Laboratoire de psychologie clinique psychopathologie psychanalyse, Paris Cité University, PCPP, 92100 Boulogne-Billancourt, France; Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France. Electronic address: dr.emilie.carretier@gmail.com.
² Département de médecine légale, université Paris Sorbonne Cité, Paris, France; Service de médecine légale et pénitentiaire, centre hospitalo-universitaire Pontchaillou, Rennes, France.
³ Service de gynecologie-obstétrique - maison des femmes, hôpital Pitié-Salpêtrière, AP-HP, Sorbonne université, Paris, France.
⁴ Département de psychiatrie et de médecine addictologique, site Lariboisière Fernand-Widal, AP-HP GHU Nord, 75010 Paris, France.
⁵ Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France; Service de psychiatrie de l'enfant et de l'adolescent, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; Université Clermont-Auvergne, 63000 Clermont-Ferrand, France.
⁶ Laboratoire de psychologie clinique psychopathologie psychanalyse, Paris Cité University, PCPP, 92100 Boulogne-Billancourt, France; Paris-Saclay University, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France; Maison des adolescents - maison de Solenn, hôpital Cochin, AP-HP, 75014 Paris, France.

PMID: 38523028
DOI: 10.1016/j.encep.2023.12.003

Abstract

Objectives: The aim of the study is to describe the population of adolescents who have disclosed sexual abuse to a health professional during their care in a psychiatric department. We also want to discuss the circumstances that enable adolescents to make this disclosure.

Methods: This single-center retrospective observational study is based on the mandatory reports (n=139) sent by a Paris adolescent psychiatry department between 2005 and 2021 after patients disclosed previous sexual abuse. R® (3.6.1) and RStudio® (1.2.5001) software were used for statistical analysis.

Results: Girls accounted for almost all the adolescents who disclosed (95.7%). First abuse occurred around the age of 12 years and was first disclosed to a health professional a mean of 3.5 years later; 66 (47.5%) patients were admitted for inpatient care during their follow-up. The most common diagnoses were depression, eating disorders, posttraumatic stress disorders, and other anxiety disorders. Before disclosing to a health professional, most of these adolescents had already talked about it, mainly to a family member (69.8%) or peers (24.7%).

Conclusion: This is the first study in France on the reporting of sexual abuse after its disclosure by adolescents being treated in a psychiatry unit. Our results show that child sexual abuse is rarely reported and that health care professionals are far from being the first recipients of these disclosures. We recommend routine screening for sexual abuse in adolescent psychiatry units, improved training for staff receiving these disclosures, and consideration of how best to coordinate medical, social, and legal services for these adolescents.

Keywords: Adolescents; Child sexual abuse; Disclosure; Mandatory reporting; Psychiatrie; Psychiatry; Révélation; Signalement; Violences sexuelles.