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A systematic review of short and medium-term mental health outcomes in young people following sexual assault Introduction Sexual assault is common worldwide, peaking in mid-to-late adolescence. Global estimates for women having ever experienced non-partner sexual violence were 7.2% in 2010, with the highest rates of up to 21% of women in areas of Sub-Saharan Africa [1]. Intimate partner sexual violence against women is also common worldwide, with prevalence varying by countryfrom 5%, to up to 69% of women having ever experienced this form of sexual violence [2]. Adolescents are the group at the highest risk of sexual assault in the UK [3] with 17.8% of females aged 18-24 disclosing previous sexual abuse [4]. Figures globally appear similar, with 17.4% of females and 4.2% of males from age 1 month to 17 years experiencing sexual assault at some time in the USA [5], and 14.61% of females and 9.99% of males aged 15-17 reporting lifetime sexual victimization in South Africa [6]. Associations between sexual abuse and adverse psychiatric outcomes have long been reported in the literature, with the strongest evidence for links with depression, post-traumatic stress disorder (PTSD), eating disorders, and suicide attempts [7-11]. However, the cross-sectional design of most studies limits the inferences that can be drawn from the results. This also makes it difficult to distinguish between the acute consequences of an index assault, lifetime psychiatric outcomes, and the progress of symptoms over time. We conducted a comprehensive systematic review to evaluate the evidence around short and medium-term (i.e. within three years of assault) mental health outcomes in young people sexually assaulted between the ages of 10 and 24 years. Methods The protocol for this review was developed by clinicians and academics working in the fields of child and adolescent psychiatry, adolescent medicine, and sexual assault. The reporting of results was based on the guidelines provided by the Meta-analyses and Systematic Reviews of Observational Studies group (MOOSE guidelines) [12]. Study question What are the short and medium-term effects on mental health of sexual assault between the ages of 10 and 24 years? Databases and search strategies Five databases (Medline (Ovid), Embase (Ovid), CINAHL (Ebscohost), OpenGrey, and PsycINFO were searched on the 30 th of October 2013 by two reviewers. This search was updated in 2016 and again in November 2018, using Medline and Embase databases only.

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