Diagnosed and self-reported childhood abuse in national and regional samples of child and adolescent psychiatric patients: prevalences and correlates.

We investigated if rates of ICD-10 axis 5 abuse diagnoses in the total child psychiatric population in Norway were different from self-reported abuse at 12-18?years of age, and we investigated their respective correlates. Study 1: The official registers of the total child psychiatric population in Norway in the years 2000 and 2001 were analysed for rates and correlates of axis 5 diagnoses of sexual and physical abuse. Study 2: Self-reports of abuse and neglect in a representative clinical sample of 129 adolescents referred during the same period were analysed for rates and correlates Prevalence of diagnosed sexual abuse inside and outside the family was low (1.6% and 1.9%, respectively) in the total Norwegian clinical population, and physical abuse diagnoses were even lower (0.4%). Self-reports of abuse and neglect were much higher (60.2%). One-fourth (25.5%) of the adolescents reported more than one kind of abuse. Self-reports of abuse were associated with referral for depression, symptoms of depression and suicidal risk. Patients reporting physical abuse were more often intoxicated by alcohol, used solvents and cannabis, and scored higher on the Youth Self-Report externalizing syndrome. There is a large discrepancy between rates of ICD-10 axis 5 diagnoses of sexual and physical abuse and self-reports of such abuse. Childhood abuse needs more attention in clinical practice within child and adolescent psychiatry. Physical abuse needs to be addressed in particular.