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Carretier E, Jourdan M, Duchesne S, Flouriot J, Lachal J, Moro MR. Disclosure of sexual abuse by adolescents treated in a psychiatry department. L'ENCEPHALE 2024:S0013-7006(24)00043-5. [PMID: 38523028 DOI: 10.1016/j.encep.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 03/26/2024]
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.
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Affiliation(s)
- Emilie Carretier
- 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.
| | - Marine Jourdan
- Département de médecine légale, université Paris Sorbonne Cité, Paris, France; Service de médecine légale et pénitentiaire, centre hospitalo-universitaire Pontchaillou, Rennes, France
| | - Sophie Duchesne
- Service de gynecologie-obstétrique - maison des femmes, hôpital Pitié-Salpêtrière, AP-HP, Sorbonne université, Paris, France
| | - Julien Flouriot
- Département de psychiatrie et de médecine addictologique, site Lariboisière Fernand-Widal, AP-HP GHU Nord, 75010 Paris, France
| | - Jonathan Lachal
- 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
| | - Marie-Rose Moro
- 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
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Carretier É, Jarry I, Moro MR. [The disclosure of sexual violence by adolescents: clinical and therapeutic complexity]. Soins Psychiatr 2022; 43:16-19. [PMID: 35598909 DOI: 10.1016/j.spsy.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Despite the frequency and traumatic impact of sexual violence, very few victims allow themselves to speak. Two clinical cases allow us to discuss the modalities of support for adolescents who reveal, during their psychiatric follow-up, that they have been victims of such violence.
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Affiliation(s)
- Émilie Carretier
- Maison de Solenn, Maison des adolescents de l'hôpital Cochin (AP-HP), unité Inserm 1178, 97, boulevard de Port-Royal, 75014 Paris, France.
| | - Irène Jarry
- Maison de Solenn, Maison des adolescents de l'hôpital Cochin (AP-HP), unité Inserm 1178, 97, boulevard de Port-Royal, 75014 Paris, France
| | - Marie Rose Moro
- Maison de Solenn, Maison des adolescents de l'hôpital Cochin (AP-HP), unité Inserm 1178, 97, boulevard de Port-Royal, 75014 Paris, France
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Carretier E, Lachal J, Franzoni N, Guessoum SB, Moro MR. Disclosure of Sibling Sexual Abuse by Hospitalized Adolescent Girls: Three Case Reports. Front Psychiatry 2021; 12:792012. [PMID: 35145439 PMCID: PMC8821155 DOI: 10.3389/fpsyt.2021.792012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Although sibling sexual abuse (SSA) may be the most common type of intrafamilial sexual abuse, it has not been widely studied. The lack of studies makes it very difficult for clinicians to create a comprehensive framework about this complex phenomenon, particularly in comparison with other forms of intrafamilial sexual abuse, such as father-daughter incest. SSA is still underrecognized and underdisclosed but it has the potential to be every bit as harmful as sexual abuse by a parent. The topic rarely finds its way into the more general psychiatry or social work literature. It is imperative to increase healthcare practitioners' awareness of this complex subject to improve their ability to listen to, detect, and manage the disclosures of SSA in adolescent populations. This paper presents vignettes of three 13-to-15-year-old adolescent girls who disclosed SSA during inpatient hospitalization in an adolescent psychiatric and medicine department. These cases illustrate the complexity of SSA, which has been associated with a wide spectrum of both mental and physical symptoms. Adolescent victims of SSA experience serious distress, with various and numerous psychiatric manifestations, including but not limited to depression and suicide attempts, addictive behaviors, post-traumatic stress symptoms, and eating disorders. Physical symptoms should also alert practitioners: adolescent survivors are more likely to be affected by somatic complications such as sexually transmitted diseases, chronic pain, urogenital symptoms, and nutritional disorders. We offer some recommendations to improve the detection and support of distressed adolescents disclosing SSA. Listening to them and offering a protective multidisciplinary response can limit the lasting damage and contribute to the repair process.
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Affiliation(s)
- Emilie Carretier
- Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Maison de Solenn, Paris, France.,Université de Paris, Département Laboratoire de Psychologie Clinique Psychopathologie Psychanalyse, Boulogne-Billancourt, France.,University Paris-Saclay, UVSQ, INSERM, CESP, Team ≪ DevPsy ≫, Villejuif, France
| | - Jonathan Lachal
- University Paris-Saclay, UVSQ, INSERM, CESP, Team ≪ DevPsy ≫, Villejuif, France.,Département de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, Département de Médecine, Clermont-Ferrand, France
| | - Nina Franzoni
- Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Maison de Solenn, Paris, France.,Université de Paris, Département Laboratoire de Psychologie Clinique Psychopathologie Psychanalyse, Boulogne-Billancourt, France
| | - Selim Benjamin Guessoum
- Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Maison de Solenn, Paris, France.,Université de Paris, Département Laboratoire de Psychologie Clinique Psychopathologie Psychanalyse, Boulogne-Billancourt, France.,University Paris-Saclay, UVSQ, INSERM, CESP, Team ≪ DevPsy ≫, Villejuif, France
| | - Marie Rose Moro
- Assistance Publique des Hôpitaux de Paris, Hôpital Cochin, Maison de Solenn, Paris, France.,Université de Paris, Département Laboratoire de Psychologie Clinique Psychopathologie Psychanalyse, Boulogne-Billancourt, France.,University Paris-Saclay, UVSQ, INSERM, CESP, Team ≪ DevPsy ≫, Villejuif, France
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