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Diagnoses of sexual abuse and their common registered comorbidities in the total population of Stockholm
  1. Gita Rajan1,2,
  2. Gunnar Ljunggren3,4,
  3. Per Wändell1,2,
  4. Lars Wahlström5,
  5. Carl-Göran Svedin6,
  6. Axel C Carlsson1,7
  1. 1Division for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
  2. 2Academic Primary Healthcare Centre
  3. 3Public Healthcare Services Committee Administration, Stockholm County Council, Stockholm, Sweden
  4. 4Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
  5. 5Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
  6. 6Barnafrid, Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden
  7. 7Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
  1. Correspondence to Dr Axel C Carlsson, Division of Family Medicine, Karolinska Institutet, Alfred Nobels Allé 12, Huddinge 141 83, Sweden; axelcefam{at}


Background Prior research based on self-reports has proven sexual abuse to be a risk factor for pain and psychiatric disorders. However, less is known about how this is reflected within the healthcare system. The aim of this study was to study the 2-year prevalence of diagnosis of sexual abuse and concomitant conditions.

Methods Using data from VAL, the study population included all living persons in Stockholm County, Sweden, between 1 January 2008 and 31 December 2014 (N=2 549 496). Diagnoses of sexual abuse were identified during 2013–2014, with information on the concomitant conditions somatic pain, depression, anxiety, psychotic disorders and bipolar disorders, stress disorders and alcohol and substance abuse. All diagnoses were prospectively registered. Age and neighbourhood socioeconomic status-adjusted ORs with 95% CIs for individuals with a diagnosis of sexual abuse, using individuals without sexual abuse as referents, were calculated.

Results Girls at the ages 13–17 years had the highest 2-year prevalence (0.69%) of sexual abuse followed by girls 5–12 years (0.11%), and girls 0–4 years (0.04%). For women 45 years and older the 2-year prevalence rates were substantially lower (0.008–0.004%). The highest 2-year prevalence of sexual abuse in men was seen in boys 5–12 (0.03%) years. The total 2-year prevalence of diagnoses of sexual abuse among the population in the material was 0.04%. The highest ORs of comorbidities for girls (ages 0–17 years) with sexual abuse versus those without sexual abuse were: Stress disorder; 15.7 (13.1 to 18.9), drug abuse; 10.0 (7.7 to 13.0), and alcohol abuse; 9.7(7.8 to 12.0). For boys (ages 0–17 years), the highest ORs of comorbidities were: Stress disorder 12.4 (6.0 to 25.7), anxiety disorders; 5.5 (2.6 to 11.5), and alcohol abuse; 3.9 (1.4 to 11.3). The highest ORs of comorbidities for women (18–) with sexual abuse versus those without sexual abuse were: alcohol abuse; 19.3 (12.6 to 29.6), drug abuse; 16.7 (10.7 to 26.1) and psychotic disorders; 15.3 (8.0 to 29.4). For men (18–) the highest ORs of comorbidities were: alcohol abuse; 25.8 (15.2 to 43.9), anxiety disorders; 14.3 (8.5 to 24.2) stress disorder; 12.9 (7.5 to 22.1) and drug abuse; 12.9 (6.9 to 24.1).

Conclusions Diagnoses of drug and alcohol abuse, psychotic, bipolar, stress anxiety disorders, depression and somatic pain are more common among individuals with a diagnosis of sexual abuse than among individuals without a diagnosis of sexual abuse.

  • Social and life-course epidemiology
  • Epidemiology of chronic non communicable diseases

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  • Contributors GR drafted the manuscript and contributed to all sections. GL and PW researched data, were involved in study design and critical revision of the manuscript. LW and C-GS contributed to knowledge in the field, background info and discussion, critical revision of the manuscript. ACC supervised GR and contributed to all sections of the mansucript.

  • Funding ACC received funding from the Stockholm County Council (ALF), for a project investigating a novel therapy for victims of sexual abuse.

  • Competing interests GR is the founder and secretary general of the non-profit organisation World of No Sexual Abuse, WONSA.

  • Ethics approval Ethical board in Stockholm.

  • Provenance and peer review Not commissioned; externally peer reviewed.