‘Doctors should ask patients about abuse’

Asking adult patients with symptoms of depression, anxiety, suicidal tendencies or obsessive-compulsive disorder about their history of child sexual abuse (CSA) can save them from psychiatric morbidity. However, several doctors ignore doing so and this further aggravates their mental conditions or delays the treatment.

This was highlighted in a review paper published by the department of psychiatry department of Lokmanya Tilak Medical College in association with Lawson Health Research Centre, London.

According to the review paper, a child with CSA can develop depression, anxiety disorder and self-injurious behaviour. Many of them feel angry or guilty for being at the spot. Also, when their family members do not believe them, they end up not expressing their feelings. Later, in their life, they show several signs of psychiatric morbidity and develop the need to seek help from psychiatrists.

Hence, the medical experts opine that it is necessary to check their history related to CSA of the patients to identify sexual abuse cases. “The more late a doctor is at asking them about sexual abuse, the tougher it becomes to improve their mental condition. For years, the patients might not show any symptoms. It may come into the fore suddenly. So, if a psychiatrist does not enquire about it to the patient in their first sitting, it delays the treatment as in most of the cases patients end up not revealing the abuse at all,” said Dr Avinash De Sousa from the college who was the main correspondent of the review.

“Out of the total cases we receive, 30-35 per cent of the adult patients have a history of abuse cases. Many of them also get addicted to drugs, tobacco and alcohol that further makes them involved in anti-social or criminal activities,” he added.

According to several findings including the report published by Union department of women and child development in 2007 on child abuse, more than 40 per cent of children have suffered from sexual abuse.

Dr Sagar Mundada, psychiatrist at JJ Hospital, highlighted a similar issue. “CSA cases are very sensitive issues that mostly go unreported. That’s one of the reasons why many times, psychiatrists also do not question about it even though it is necessary. When children get abused, it gets ingrained in the subconscious mind. Later, when they face a similar situation or any kind of abuse, the memories are revived,” said Dr Mundada.

“However, with rising cases of CSA, psychiatrists have started enquiring about such issues while collecting information about the patients’ personal history,” he said.