OBJECTIVE: There is an increased oxidative stress process in psychiatric disorders that may result due to a chronic stress exposure. Lipid peroxidation and chronic inflammation also increases oxidative stress according to the model of inflammation observed in psychiatric diseases. Oxidative stress can also damage central nervous system by glutamate-mediated excitotoxicity and hyperstimulation of N-methyl-D-aspartate (NMDA) receptors. Direct studies examining the relationship between sexual abuse and oxidative stress are limited in the literature. In this study, we aimed to investigate the oxidative stress parameters, psychopathologies and related sociodemographic factors in adolescents exposed to sexual abuse.
METHOD: Patients aged between 10-17 years who had been sexually abused and had a history of at least 1 year were compared to age and sex matched control cases. The socio-demographic information of the participants obtained with a detailed form which was made by the researchers. Assessment of psychopathology and clinical functioning was carried out with the Turkish version of the Affective Disorders and Schizophrenia Interview for Children- Present and Lifetime Version (K-SADS-PL). Adolescents were also evaluated with "Beck Depression Inventory", "Beck Anxiety Scale", "Post Traumatic Response Scale", "Ways of Coping Inventory", "Strengths and Difficulties Scale", and "List of Negative Life Events".
RESULTS: Our sample consisted of 50 cases of sexual abuse (42 girls and 8 boys) and 40 controls (32 girls and 8 boys). The mean age of the cases was found to be 14,88 ± 2,16 years in the abuse group and 14,90 ± 2,18 years in the control group. School continuity in the sexual abuse group is significantly lower. And also sexual abuse cases were coming from distressed families with relatively much lower monthly income. Penetration was 60% and physical violence was 46% reported during abuse. Suicide attempt was described 34% in abuse group. Prior to abuse, psychiatric referrals were present in 46% of the cases. The most frequent diagnoses after abuse were 78.2% Post Traumatic Stress Disorder (PTSD), 78.2% depression and 60.8% specific phobia. WISC-R scores in the abuse group were lower than controls. Functionality scores were lower than controls whereas Beck Depression Inventory, Beck Anxiety Scale, Post Traumatic Response Scale and scores of Negative Life Events Scales were higher in the study group.
CONCLUSION: Level of oxidative stress assessed by total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) showed a significant higher oxidative stress and diminished antioxidant process profile in sexual abuse group. TOS and OSI values were significantly higher while TAS values were significantly lower than controls. The fact that the oxidative stress mechanism which accelerates the cell cycle, leads to premature cell death that may result in many neuropsychiatric illnesses has been described in this study of abused adolescents. A more detailed study of oxidative stress mechanisms in adolescents in terms of an increase in the risk of physical disease, as well as possible adverse effects on life span and deterioration in quality of life as well as increased risk of acquiring a chronic illness would be meaningful in seeking answers to epigenetic questions.
Key words: sexual abuse, adolescent, oxidative stress, total oxidant status, total antioxidant status, psychopathology
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