Electronic Letters to:

PAPERS:
Josie Spataro, Paul E. Mullen, Philip M. Burgess, David L. Wells, and Simon A. Moss
Impact of child sexual abuse on mental health: Prospective study in males and females
The British Journal of Psychiatry 2004; 184: 416-421 [Abstract] [Full text] [PDF]
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[Read eLetter] Would this qualify for a prospective study?
Nandini Chakraborty   (4 June 2004)

Would this qualify for a prospective study? 4 June 2004
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Nandini Chakraborty,
SHO (Psychiatry)
Ayrshire and Arran NHS Trust

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Re: Would this qualify for a prospective study?

nandini_dass{at}rediffmail.com Nandini Chakraborty

The title of this paper proclaims that the study was a prospective one. A prospective study, by definition, is one that looks into the future when the research was started or planned. Though the authors have looked into the future mental health impact of child sexual abuse, it seems quite obvious that the study itself was done with the data being collected retrospectively.

The authors have retrospectively identified their subjects by checking a register which records child sexual abuse. They have also retrospectively collected data regarding contact with the mental health services for a specified period (1 July 1991–30 June 2000). The methodology, other than being retrospective in nature, includes other flaws that have not been mentioned in the limitations of the study.

Since the subjects' contacts with psychiatric services have been studied over only a specific period of time, valuable data may have been lost if a subject presented earlier. What if some of the subjects had committed suicide before July 1991?

A lot of potential data seem to have been lost in this study, but the authors admit the limitations, including the fact that some patients may have presented to the private sector and are thus not on the Victorian Psychiatric Case Register and that the diagnostic hierarchy used in the study may have skewed some of the results.

A proper prospective study might have been able to tell us more. If the subjects were identified at the beginning of the study and then traced at the end of a specific follow up period, it might have been possible to pick up the subjects lost to the private sector, death or those who presented with a short lasting episode of mental illness before the period of follow-up specified in the present study.