{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:08:23Z","timestamp":1784196503079,"version":"3.55.0"},"posted":{"date-parts":[[2026,7,13]]},"group-title":"Psychiatry and Clinical Psychology","reference-count":59,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,7,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Importance<\/jats:title>\n                  <jats:p>Childhood sexual abuse (CSA) is linked to adverse psychiatric outcomes in adulthood, but evidence on its association with cardiovascular disease and mortality from large, diagnostically ascertained cohorts remains limited.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the 10-year risk of all-cause mortality, suicide or self-harm, drug overdose or poisoning, and cardiovascular disease among patients with a diagnosed history of CSA compared with a matched unexposed cohort.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this retrospective cohort study, we used deidentified electronic health record data from 68 health care organizations in the TriNetX US Collaborative Network. Patients diagnosed with confirmed or suspected childhood sexual abuse (CSA) before age 18 between January 1, 2003, and December 31, 2015, who had a subsequent adult encounter, were propensity score matched 1:1 with unexposed patients on age, sex, race and ethnicity, and baseline psychiatric and medical comorbidities (n = 9,083 per cohort). Outcomes\u2014all-cause mortality, suicide or self-harm, drug overdose or poisoning, and cardiovascular disease\u2014were assessed over 10 years from the index adult encounter using risk and time-to-event analyses to estimate risks, risk ratios, and hazard ratios.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 18,166 matched patients (mean [SD] age, 19.0 [2.0] years; 14,813 [81.6%] female), CSA was associated with significantly elevated risk of suicide or self-harm (5.1% vs 2.8%; risk ratio [RR], 1.84; 95% CI, 1.57-2.16), drug overdose or poisoning (5.5% vs 3.7%; RR, 1.47; 95% CI, 1.28-1.69), and cardiovascular disease (12.3% vs 9.3%; RR, 1.31; 95% CI, 1.20-1.44), with concordant hazard ratios (all P &lt; .001). All-cause mortality was numerically higher but not statistically significant (0.5% vs 0.4%; RR, 1.16; 95% CI, 0.75-1.79; P = .51).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions and Relevance<\/jats:title>\n                  <jats:p>A diagnostically confirmed history of CSA was associated with substantially elevated 10-year risk of self-harm, overdose, and cardiovascular disease, independent of baseline demographic and psychiatric comorbidity. These findings support integrated psychiatric and cardiovascular screening for adult survivors of CSA and trauma-informed care extending beyond mental health services alone.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.07.09.26357627","type":"posted-content","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T18:15:14Z","timestamp":1783966514000},"source":"Crossref","is-referenced-by-count":0,"title":["Childhood Sexual Abuse and Long-Term Risk of Self-Harm, Overdose, and Cardiovascular Disease"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8530-3681","authenticated-orcid":false,"given":"Oluwasegun","family":"Akinyemi","sequence":"first","affiliation":[{"name":"The Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olububechukwu","family":"Eze","sequence":"additional","affiliation":[{"name":"The Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojisola","family":"Fasokun","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Olaosebikan","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Information Science"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Temitayo","family":"Ogundipe","sequence":"additional","affiliation":[{"name":"Department of Hospital Medicine, Sentara Williamsburg Regional Medical Center, Williamsburg, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delia","family":"Singleton","sequence":"additional","affiliation":[{"name":"The Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayomide","family":"Ogunsakin","sequence":"additional","affiliation":[{"name":"The Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar","family":"Khalil","sequence":"additional","affiliation":[{"name":"The Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5627-9655","authenticated-orcid":false,"given":"Kaelyn","family":"Gordon","sequence":"additional","affiliation":[{"name":"The Clive O Callender Outcomes Research Center, Howard University College of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Micheal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Howard University College of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kakra","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Surgery, Howard University College of Medicine, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7061-0013","authenticated-orcid":false,"given":"Temitope","family":"Ogundare","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, New York Presbyterian Columbia University Medical Center & Columbia University Vagelos College of Physicians and Surgeons, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026071602450538000_2026.07.09.26357627v1.1","unstructured":"Daley SF , Gonzalez D , Bethencourt Mirabal A , Afzal M. 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