Abstract
BACKGROUND: Child sexual abuse (CSA) has profound psychiatric and developmental consequences; however, the relationship between specific abuse characteristics and mental health outcomes in the Indian context remains insufficiently studied. This study examined psychiatric morbidity, developmental psychopathology, and functional impairment among children with CSA. METHODS: A cross-sectional study was conducted with 100 children aged 6-17 years whose cases were registered under the Protection of Children from Sexual Offenses (POCSO) Act and referred to a government-supported protection center. Data were collected using a semi-structured interview, the Developmental Psychopathology Checklist (DPCL), DSM-5-TR-based clinical evaluations, and the Children's Global Assessment Scale (CGAS). Associations between abuse characteristics and psychiatric outcomes were analyzed using χ (2) tests and logistic regression. RESULTS: The mean age was 10.87 years (SD = 3.22). Perpetrators were known to the child in 66% of cases, and 55% of participants experienced vaginal or anal penetration. Overall psychiatric morbidity was 53% (95% CI: 43.2-62.6). Common diagnoses included post-traumatic stress disorder (28%, 95% CI: 20.0-37.6), conduct disorder (21%, 95% CI: 14.2-30.0), and depression (17%, 95% CI: 10.9-25.5). Suicidality was reported in 12% (95% CI: 6.8-19.8). Vaginal/anal penetration was associated with higher rates of PTSD (χ (2) = 8.67, p = .003) and depression (χ (2) = 4.15, p = .04). Longer duration of abuse was associated with higher suicidality (χ (2) = 6.30, p = .01). More severe physical injury was associated with higher suicidality (χ (2) = 6.30, p = .01). Self-blame was associated with higher rates of adjustment disorder (χ (2) = 4.98, p = .02). The mean CGAS score was 69.20 (SD = 12.16), reflecting mild-to-moderate functional impairment. CONCLUSIONS: CSA survivors exhibit substantial psychiatric and functional difficulties, with specific abuse patterns linked to distinct mental health outcomes. Early trauma-focused assessment, caregiver psychoeducation, and timely psychosocial interventions are crucial to improving recovery trajectories.