Prevalence of adult sexual abuse in men with mental illness: Bayesian meta-analysis

BACKGROUND: Sexual abuse is a broad category of traumatic experiences that includes rape and any unwanted sexual contact with a body part or foreign object, whether penetrative, oral or otherwise. Although patients with mental illness have a higher risk of becoming victims of sexual abuse in adulthood, few studies investigate the proportion of male victims in this population. Their underrepresentation in research is a barrier to understanding the negative outcomes associated with sexual abuse in men. AIMS: We estimated the prevalence of recent (past year) and adulthood sexual abuse perpetrated by any perpetrator and separately by intimate partners in males diagnosed with a mental illness. METHOD: To model the prevalences and heterogeneity arising from reports, we used Bayesian multilevel models. Prevalences were estimated for mixed-diagnosis, substance misuse, intellectual disability and post-traumatic stress disorder samples, and studies reporting specifically on intimate partner violence. This review was registered through PROSPERO (CRD42020169299) RESULTS: Estimated adult sexual abuse was 5.3% (95% Credibility Interval 1.6–12.8%) for past-year abuse and 14.1% (95% Credibility Interval 7.3–22.4%) for abuse in adulthood. There was considerable heterogeneity of prevalence between studies and diagnosis groups. CONCLUSIONS: Our analyses show that the prevalence of sexual abuse of males diagnosed with a mental illness was much higher than for men in the general population. This has important implications regarding the proportion of undetected or untreated sexually abused men in clinical practice.