Psychiatric aspects of sexual abuse involving persons with developmental disabilities.

OBJECTIVE: To consider psychiatric issues that relate to the prevention and management of sexual abuse involving persons with developmental disabilities as either abusers or victims.

METHOD: Seven case descriptions illustrate the clinical challenges raised by allegations of sexual abuse.

RESULTS: Mental disorders and communication problems often coexist with the cognitive impairment that is primary in developmental disabilities. Pedophilic behaviour prompts allegations of abuse, and posttraumatic stress disorder often follows abuse. Difficulties communicating with others may preclude the detection of abuse or normal legal proceedings once an allegation is made.

CONCLUSIONS: Psychiatric expertise applied both directly and indirectly through others is relevant in the prevention of sexual abuse and the management of those with developmental disabilities who are abusers or abused.