Exposure of populations with psychosis to traumatic events (among them sexual trauma) has seldom been studied. In addition, the clinical features developed by victims with psychosis after a traumatic event are rarely taken into account. Sixty-four women with schizophrenia and 26 women with bipolar disorder (DSM-III-R diagnosed, 18-45 years, inpatients and outpatients) were interviewed using a clinician-rated battery of instruments, including a semi-structured questionnaire concerning sexual victimization and its impact. In childhood or adolescence, 36% of women with schizophrenia (vs 28% of those with bipolar disorder) had been victims of sexual abuse involving body contact. In the women with schizophrenia, this sexual abuse was associated with addictions, suicide attempts and becoming psychiatric patients earlier. Over their lifetime, the prevalence of rape was 23% in the two clinical groups. In women with schizophrenia, rape was associated with a greater severity of their disorder and addictions. Moreover, a frequent repetition of sexual trauma was observed in women with schizophrenia, whereas such repeated traumas were less frequent in those with bipolar disorder. The results suggest that these two clinical groups are at risk of rape and the study highlight clinical features in victims with schizophrenia that have been described for other groups of victims of sexual abuse.
Clinicians are familiar with the life and psychological difficulties of incest victims, but their observations often are refuted as being retrospective and unsystematic. We aimed to ascertain similarities and differences between incestuous rape and nonincestuous rape. One hundred and two victims consulting a French forensic center were interviewed in a systematic follow-up study over 6 months using structured interview schedules. Stepwise logistic regression analysis adjusted for age, gender, and characteristics of the trauma showed that posttraumatic stress disorder, dissociative disorders, agoraphobia, and low self-esteem were overrepresented in the incest-rape group compared to the nonincest-rape group.
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