Child sexual abuse as an adverse childhood experience: a six-patient case series from a psychiatric hospital

Abstract

Adverse childhood experiences (ACEs), particularly sexual abuse, represent a major risk factor for severe psychiatric morbidity in children and adolescents. This study presents a case series of six minors hospitalized in 2025, in a psychiatric unit following sexual abuse, with emphasis on clinical presentations, diagnoses, and treatment outcomes. Data were retrospectively collected from medical records of six patients (ages 5–15 years; 4 females, 2 males). Extracted variables included demographics, family and psychiatric history, type of abuse, presenting symptoms, diagnosis, treatment, and short-term prognosis. All patients reported severe sexual abuse, intrafamilial (paternal perpetrators) or extrafamilial. Associated risk factors included parental alcoholism and neglect. Symptomatology at admission comprised emotional dysregulation, sleep disturbances, irritability, somatic complaints, and social withdrawal. Two patients presented suicidal ideation, while one developed earlyonset schizophrenia with psychotic symptoms. Diagnoses included conduct and emotional disorders (ICD-10: F92.8), F 33.3 Major depressive disorder, recurrent, severe with psychotic symptoms, and F 20.3 Undifferentiated Schizophrenia. Treatments involved mood stabilizers (Carbamazepine), antipsychotics (Aripiprazole, Risperidone), and supportive interventions. Prognosis remained guarded, with recurrent hospitalizations in severe cases. Childhood sexual abuse is strongly associated with a spectrum of psychiatric disorders, including PTSD, affective dysregulation, and psychotic illnesses. The presence of suicidal ideation in early adolescence underscores the severe risk of self-harm in traumatized minors. Early-onset schizophrenia, observed in this series, may be triggered or exacerbated by traumatic exposures, highlighting the complex interplay between ACEs and vulnerability to severe mental disorders. These findings reinforce the urgent need for trauma-informed psychiatric care, systematic screening, and multidisciplinary therapeutic approaches.