Objective: The present study aimed to determine whether psychiatric comorbidity (i.e., diagnostic comorbidity in eight categories of mental and behavioral disorders) mediates the relationship between childhood sexual abuse (CSA) and diseases of the genitourinary system (International Statistical Classification of Diseases and Related Health Problems, 10th revision) among girls. Method: Using a prospective matched-cohort design, we documented diagnoses given by a physician after a medical consultation or hospitalization for diseases of the genitourinary system, for 661 sexually abused girls and 661 matched controls via administrative databases covering the period between January 1996 and March 2013. Path analyses using negative binomial regressions with CSA as independent variable, psychiatric comorbidity as mediator and genitourinary diseases diagnoses as dependent variables were performed. Results: After controlling for socioeconomic level, prior genitourinary diseases and number of years of medical data, the mediation effect for the path from CSA to genitourinary diseases through psychiatric comorbidity was significant for the urinary system (b = .125, 95% confidence interval [0.057, 0.192]) as well as for the genital system (b = .213, 95% confidence interval [0.141, 0.285]). Psychiatric comorbidity carried 62% of the sexual abuse total effect on the number of diagnoses received for genital diseases, whereas it carried 23% of the sexual abuse total effect on the number of diagnoses received for urinary diseases. Conclusions: Findings suggest that CSA may have an indirect effect on girls' diagnosed genitourinary diseases during a medical consultation or hospitalization through the increased risk for psychiatric comorbidity. Early interventions aimed at addressing psychological distress among sexually abused girls might prevent the emergence of genitourinary diseases years after the abuse. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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童年性虐待，女孩的泌尿生殖系统疾病和精神病合并症：一项队列研究。

目的：本研究旨在确定精神病合并症（即八类精神和行为障碍的诊断合并症）是否介导了儿童性虐待（CSA）和泌尿生殖系统疾病之间的关系（国际疾病和相关健康统计分类）问题，第10版）。方法：采用前瞻性配对研究设计，我们通过1996年1月至3月期间的行政数据库，记录了医生对生殖器泌尿系统疾病进行医疗咨询或住院后对661名性虐待女孩和661名对照者的诊断。 2013。使用CSA作为自变量的负二项式回归进行路径分析，进行精神​​疾病合并症作为介体，泌尿生殖系统疾病诊断为因变量。结果：在控制了社会经济水平，先前的泌尿生殖系统疾病和医疗数据的年限之后，通过精神病合并症从CSA到泌尿生殖系统疾病的传播途径对泌尿系统的影响显着（b = .125，95％置信区间[ 0.057，0.192]）和生殖器系统（b = .213，95％置信区间[0.141，0.285]）。精神病合并症对生殖器疾病的诊断次数占总性虐待的62％，而对泌尿系统疾病的诊断数占总性虐待的23％。结论：研究结果表明，CSA可能间接影响女孩的 在医疗咨询或住院期间通过增加精神病合并症的风险诊断出泌尿生殖系统疾病。旨在解决遭受性虐待的女孩的心理困扰的早期干预措施可能会防止在受虐多年后出现泌尿生殖道疾病。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。