Introduction: Prevalence of child sexual abuse in Sri Lanka ranges between 14%-44% with rates of sexual harassment as high as 78.5%. Hospital based studies done in Sri Lanka have shown a wide variation in the number presenting to hospitals with child sexual abuse. Child sexual abuse is associated with a wide range of psychosocial adversities.Objectives: To identify the victim/perpetrator characteristics, risk factors, pattern of disclosure and psychological consequences of child sexual abuse presenting to a Teaching Hospital in Sri Lanka.Method: This was a retrospective case review study of victims who presented to a Teaching Hospital in Sri Lanka with sexual abuse between 2015 and 2019.Results: During the study period 164 children presented with sexual abuse. Females comprised 82.9% and 67.1% were older than 12 years. Majority (73.6%) had penetrative abuse. Multiple incidents of abuse occurred in 58.5%. Of the perpetrators, 94.5% were known to the child. Only 42.7% revealed about the incident within the first week. Delayed disclosure was higher in penetrative abuse (p<0.01), multiple incidents of abuse (p<0.01) and abuse by a known person (p<0.05). Psychological sequelae were seen in 28.7% and were higher in those who delayed disclosure (p<0.05) and in those who did not disclose spontaneously (p<0.01). Conclusions:In this study, rate of sexual abuse was 82.9% in females and 67.1% in those older than 12 years. Of the perpetrators, 94.5% were known to the child. Delayed disclosure was significantly higher in penetrative abuse (p<0.01), _________________________________________

IntroductionParenting with mental illness is associated with parenting difficulties and increased mental health problems in children. Family focused interventions improve child outcomes by 40%. However, such services are not available at present in Sri Lanka.ObjectivesTo assess the challenges faced and perceived needs of parents with mental illness in Sri Lanka.MethodsA cross sectional descriptive study was carried out in the adult psychiatry follow-up clinics in a Teaching Hospital in Sri Lanka. A specifically designed questionnaire was used to collect socio-demographic details, difficulties with parenting and perceived care needs.ResultsOf 385 parents, 67.3% believed their mental illness impacted their parenting. Perceived impact on parenting was higher in younger parents (p<0.01), when the children were younger (p<0.01), had more children under 5 years (p<0.01) and when there was no social support (p<0.01). 67.8% of parents believed their illness impacted their children, with higher impact perceived in parents with children less than 5 years of age (p<0.05) and those with no social support (p<0.01). Although 36.4% had concerns about their children’s emotions or behaviour, only 16.4% were willing to discuss these with their doctor. The parental concerns were significantly higher where the parent was employed (p<0.01), had a longer duration of illness (p<0.01) and when the youngest child was more than 12 years (p<0.01)ConclusionsMental illness in parents had a substantial impact on parenting and their children but professionals help was rarely sought. Services aimed at the specific needs of these parents should be developed.DisclosureNo significant relationships.

IntroductionChild sexual abuse is a major public health problem in Sri Lanka, with prevalence rates ranging from 14-44%.ObjectivesWe aimed to describe the victim and perpetrator characteristics, pattern of disclosure and psychological consequences of sexual abuse in children presenting to a tertiary care hospital in Sri Lanka.MethodsThis was a retrospective file review study of 164 victims who presented to a Teaching Hospital in Colombo, Sri Lanka, with alleged sexual abuse over a period of 5 years from 2015-2019.ResultsMajority of the victims were female and older than 12 years. Majority (73.6%) have been subjected to penetrative sexual abuse with 58.5% of victims reporting more than one incident of abuse. Almost all (99.9%) of the perpetrators were male, with 94.5% being known to the child. Only 42.7% (n=70) of the children revealed about the incident within the first week. Delayed disclosure (i.e. more than 1 week since the incident) was significantly higher in penetrative abuse (p<0.01), multiple incidents of abuse (p<0.01) and in abuse by a known person (p<0.05). Children who disclosed after one week were significantly less likely to disclose about the incident spontaneously (p<0.01). Psychological sequel was seen in 28.7%, with depression being the commonest diagnosis (8.5%). Psychological consequences were significantly in higher those who had physical evidence of abuse (p<0.01), delayed (after 1 week) disclosure (p<0.05) and in those who did not disclose spontaneously (p<0.01).ConclusionsThe victim and perpetrator characteristics, pattern of disclosure is comparable with previous literature.DisclosureNo significant relationships.