May 15, 2006

BOSTON (Reuters Health) - Adolescents who say they were sexually abused are more likely to drink, smoke, use illegal drugs, exhibit eating disorders or report that they have contemplated suicide than other teens.

As a risk factor for mental health problems, "sexual abuse stood out apart from financial status, physical abuse or age," said Dr. Linda M. Barthauer of the Strong Children's Research Center at the University of Rochester in New York.

Adolescents who acknowledge sexual abuse are also more likely to say they have missed needed medical care and are in fair to poor health. But among those who report sexual abuse, only 27% of girls and 26% of boys have ever discussed the abuse with a doctor or other healthcare provider.

The reports of sexual abuse were obtained from 5,760 students in the 5th through 12th grades who responded to the question, "Have you ever been sexually abused?" in a national 1997 questionnaire about the general health of students.

This study is especially noteworthy because "the findings hold up for both boys and girls," said Barthauer. "Very few studies have been done on sexual abuse in boys."

Because sexual abuse appears to have wide-ranging effects and seems relatively common--10% of girls and 4% of boys reported sexual abuse on the questionnaire--Barthauer believes pediatricians should routinely ask their young patients about it.

"It can be done very sensitively," Barthauer said. "It is not traumatizing, and in fact, it's very helpful and therapeutic" to privately ask an adolescent about sexual abuse. Knowing that a youngster has been sexually abused may also help explain the high-risk behaviors or mental health problems that the pediatrician can help to treat.

Because of mandatory reporting requirements, some physicians are reluctant to ask about sexual abuse, Barthauer admitted. But she noted that, at a minimum, most patients can be referred to school counseling programs.

Barthauer and Karen M. Wilson, a public health specialist, presented their findings at the combined annual meeting of the Pediatric Academic Societies and the American Academy of Pediatrics.