These databases included dissertation abstracts, and our search included unpublished grey studies. We did a keyword search of titles and abstracts in four major digital databases, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, and Global Health, for papers published from database inception to Dec 31, 2018, with no language restriction. We did an umbrella review, in which information from existing meta-analyses of studies on outcomes of childhood sexual abuse was systematically collected and evaluated. Assuming causality, population attributable risk fractions for outcomes ranged from 1♷% (95% CI 0♷–3♳) for unprotected sexual intercourse to 14♴% (8♸–19♹) for conversion disorder. Quality was low for meta-analyses on borderline personality disorder and anxiety, and moderate for conversion disorder. The systematic reviews for two psychiatric outcomes (post-traumatic stress disorder and schizophrenia) and one psychosocial outcome (substance misuse) met high quality standards. Strongest psychiatric associations with childhood sexual abuse were reported for conversion disorder (OR 3♳ ), borderline personality disorder (2♹ ), anxiety (2♷ ), and depression (2♷ ). Childhood sexual abuse was associated with 26 of 28 specific outcomes: specifically, six of eight adult psychiatric diagnoses (ORs ranged from 2♲ to 3♳ ), all studied negative psychosocial outcomes (ORs ranged from 1♲ to 3♴ ), and all physical health conditions (ORs ranged from 1♴ to 1♹ ). We identified 19 meta-analyses that included 559 primary studies, covering 28 outcomes in 4 089 547 participants. The Lancet Regional Health – Western Pacific.The Lancet Regional Health – Southeast Asia.
The Lancet Gastroenterology & Hepatology.
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