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The evidence is reviewed which connects a history of sexual assault, either'during childhood or as an adult, with subsequent increases in the rates of psychiatric disorder. Studies carried out with patients, on victims, on convenience samples such as students, and on random community samples, all point to an association between sexual assault and subsequent psychopathology. Applying commonly accepted criteria for causal inference suggests that it is plausible to hypothesize a causal connection between the abuse and increased vulnerability to later affective disorder. The mechanisms by which the experience of abuse could lead to later disorder are discussed. The practical problems raised, both in terms of the decision to prosecute the abusers and compensate the victims, are illustrated. Though there are problems created by over-reaction and misplaced zeal it is essential that mental health professionals recognize and respond to the needs of the victims of sexual assault.
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