Childhood sexual abuse is a traumatic experience significantly associated with adult psychopathology and have been reported by 15-22% of adult women in the general population. Childhood histories of physical or sexual abuse are associated with a higher risk of depressive episodes, mania and psychosis. However, these problems are predicted and evaluated for near term effects, mostly neglecting the fact that these exposures substantially cause a major psychiatric disorder in the long-term, even requiring a psychiatric hospitalization. Here in this case series we present female patients with sexual abuse or rape stories, who were treated with serious major psychiatric disorders, emerging after years.
Case 1; A 24 years old female, single patient, suicidal was admitted to the psychiatric ward with the diagnosis of Major Depression. The onset of her disease started 5 years ago, after her uncle raped her 6 years ago. Number of attempted suicide was twice in the last 2 years.
Case 2; A 45 years old female patient, divorced 12 years ago, still living with her mother, was admitted to the psychiatry ward with reference delusions. She had a history of sexual and physical abuse history when she was 7. The onset of her disease is 10 years after her experience. She has been medicated for 28 years with the diagnosis of Paranoid Schizophrenia and had many suicidal attempts.
Case 3; A 51 years old female patient, who has been divorced 25 years ago and living with her sister. She was admitted to psychiatric ward with agitation, increase in speech, having auditory hallucinations. She was raped by 7 people 36 years ago, 2 years before onset of her disease. She had been admitted to psychiatry ward for 6 times.
Case 4; A 30 years old female, married for 9 years was admitted to psychiatry ward, diagnosed as depression with psychotic features. She has been suffering from auditory hallucinations for a week accompanying depressive symptoms. She was abused by her father and grandfather, when she was 7. The onset of her disease was recognized 5 years after the incident, since when she attempted suicide and had been admitted to the hospital for 5 times.
To decide the level of the penalty intentioned for abuse and rape perpetrators according to Turkish Penal Code, victims are being sent to forensic psychiatry units in order to be evaluated for the psychiatric outcomes. The evaluations mentioned are being held almost during the 6 months after the incident and the last psychiatric conclusion is made maximum 1 year after. However, we know that traumas especially that take place in the early years of human life might cause a major psychiatric disorder even after years. The onset of the psychiatric diseases in all our four cases is years after abuse or rape histories; 6, 10,2 and 5 years after. None of them has a psychiatric evaluation or any intervention after their traumatic experiences. Rape and abuse victims have the risk to have many psychiatric diseases.