Psychiatric morbidity among adult sexually abused females attending Nairobi Women's Hospital, Kenya
Date
2004Author
Onyancha-Nyabuto, Pacificah K
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
A cross-sectional study of 116 sexually abused females aged 18 years and above attending
Nairobi Women's Hospital (NWH) was carried out to determine Psychiatric Morbidity
(PM).
The following instruments were used: a socio-demographic data and sexual abuse situation
variables questionnaire, the Self Rating Questionnaire, revised version of the Impact of
Event Scale (IES-R) and the Standard Psychiatric Interview (SPI). Clinically those who
were found to be psychologically impaired were introduced tot he hospital's psychiatric
services. Data collected was analyzed using the SPSS version 10. The results were
presented in tables and figures.
The main findings were:
• The psychiatric morbidity was found to be 74.1 %., which was higher than that
noted in similar studies conducted in the developed world (43-61) %.
• The following were significantly associated with PM:
1. Number of previous sexual partners,
2. Whether the survivor generally enjoyed sex or not
3. Psychological and medical interventions in last six months,
4. Type and number of abuser,
5. Place of sexual abuse
6. Whether the meeting was planned,
7. Possession of weapon by abuser
8. Survivors defense against the attack
9. The survivor's feeling like being killed, fear panic and completely
helpless.
10. DSM IV Axis I Diagnosis was also statistically associated significantly
with development of PM.
The other factors such as religion, marital status and highest level of
education attained were found to be not statistically significant.
• The two instruments used (SRQ and IES-R) were positively correlated and found to
be measuring different pathology because they picked positivity differently.
• Majority of those who scored positive with SRQ 74/86(85.8%) met criteria for an
axis I Disorder according to DSM IV.
• According to DSM IV diagnosis, most of the sexual abuse survivors suffered from
Acute Stress Disorder (ASD) 29/74 (39.2%) and Post Traumatic Stress Disorder
(PTSD) 25/74 (33.8%) more than the other PMs.
In conclusion, from the research finding a person was most likely to be sexually assaulted
if she was a female aged between 1 8 and 29 years, single with post primary education,
while on the roadside, one who was not sexually active and had not been previously abused
sexually. The survivor usually felt like she was going to be killed, mostly overwhelmed by
the attack, was unlikely to resist the attack and could not believe t hat such a thing had
happened to her.
The abuser was most likely to be unknown to the sexual abuse survivor, was usually alone,
without any weapon and not under the influence of alcohol or other substances of
dependence.
The risk factors for developing psychiatric morbidity after sexual abuse found in this study
include;
Being single
When sexually abused by more than one person
While on the roadside
Having been previously sexually abused
Being a Muslim
Night sexual abuse
Being sexually abused on Thursday and Friday.
The fact that the PM rates among the sexually abused females attending the NWH for
counseling and medical attention was found to be higher than that found in the developed
world warrants the need for specialized psychiatric services for this group.
However, a similar study with control group is deemed to be necessary in order to compare
and confirm t he findings in this study, as the present study is a primer not only in this
country but the geographical region at large. The future research in this field should aim at
identifying best approach in dealing with the PMs. This will assist in unraveling the long term
course and hence recommend cost effective preventive and management methods for
this condition in our locality and beyond.
Citation
Masters of Medicine (Psychiatry)Publisher
University of Nairobi School of Medicine