Psychosocial and clinical profiles of children with alleged history of sexual abuse: A study from a tertiary mental health care centre in Kerala.

BACKGROUND

Given the long lasting physical and psychological effects of child sexual abuse (CSA), especially in light of its traumatic nature, and recognizing the dearth of knowledge regarding CSA and its associated risks within the context of Kerala, South India, this study endeavours to fill this critical gap.

AIM: To investigate the psychosocial and clinical characteristics of children with alleged history of child sexual abuse (CSA), particularly within the unique setting of a tertiary mental health care centre in Kerala.

METHODS

This is a retrospective chart review carried out in the child and adolescent psychiatric unit of IMHANS, Kozhikode, between January 2016 and December 2023. Data collected includes, socio demographic details, CSA characteristics, perpetrator characteristics, adherence to mandatory reporting protocols, level of willingness regarding reporting under Protection of Children from Sexual Offences Act, 2012 (POCSO Act) and the clinical profile of the victim of CSA at the time of presentation. Statistical analysis were performed using SPSS.

RESULT: The study comprised 114 children, and the mean age of the victims at the first instance of abuse was 11.3 ± 3.52 years. 92.1% of perpetrators of CSA were individuals known to the victims. The most common form of CSA was genital contact without penetration (34.2%). The commonest psychiatric diagnosis was Adjustment Disorder (28.9%). Older children were associated with lower odds of parental reluctance in reporting cases under Protection of children from sexual offense act, 2012 (B = 0.167; OR = 0.84; CI [0.730, 0.981]). The odds of parental reluctance to reporting was approximately four times higher in cases where the perpetrator is a family member (B = 1.518; OR = 4.01; CI [1.724, 9.346]).

CONCLUSION

Overall, the study emphasizes the urgent need for raising awareness regarding legal procedures as well the manifestation of psychological symptoms, promoting early detection, providing specialized interventions, and establishing robust support systems to address the complex psychological and social concerns of the child sexual abuse victims.