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Abstract SUMMARY Introduction It is difficult to assess the impact of childhood traumatic events on the psychiatric disorders in adulthood, as neither prospective research studies, nor experimental approaches are possible. Nevertheless, an increasing number of retrospective reports suggest that psychiatric disorders may be related to childhood psychological traumas. Cases of child abuse represent the “tip of the iceberg” of the real phenomenon, where only a small proportion would be seen ”above the surface”. There is incomplete and inconsistent information on the prevalence of maltreatment, its sociodemographic risk factors, and its relationship to future health The impact of child abuse and neglect is often discussed in terms of physical, psychological, behavioral, and societal consequences. In reality, however, it is impossible to separate them completely. Physical consequences (such as damage to a child’s growing brain) can have psychological implications for example: cognitive delays or emotional difficulties. Psychological problems often manifest as high-risk behaviors. Depression and anxiety, may make a person more likely to smoke, abuse alcohol or illicit drugs. Substance Use Disorder: Impact of Childhood Abuse (SUMMARY) 122 Early psychoanalytic formulations postulated that drug users, in general, suffered from either a special form of affective dysregulation (tense depression) that was alleviated by drug use or from a disorder of impulse control in which the search for pleasure was dominant. More-recent formulations postulate ego defects, which are evinced by the addict’s inability to manage painful affects (guilt, anger, anxiety) and to avoid preventable medical, legal, and financial problems. The newer formulations postulating ego defects are to some degree the older formulations with a modest change in terminology that gives greater weight to the inability to cope with painful affects than to the intensity or abnormality of the affects per se. It is postulated that some substances pharmacologically and symbolically aid the ego in controlling those affects and that their use can be viewed as a form of self-medication. Review of literature The theoretical part of this thesis involves two chapters: Chapter one: This chapter provided contemporary definitions of child abuse, various patterns of child abuse with etiological models and epidemiology of child abuse Chapter two: This chapter provided an understanding of theoretical perspectives about adolescent substance use. The causes of substance use are complex and multifaceted. The data Substance Use Disorder: Impact of Childhood Abuse (SUMMARY) 123 gathered from the literature suggest that substance use cannot be caused by a single particular factor, but by a combination of different aspects such as individual, family, peer, cultural and community factors. The prevalence of substance use, substances used, theoretical perspectives about the origin of substance use, effects of substance. Aim of the work: Identify the possible relationship between history of childhood abuse and the current substance use disorder and severity of associated complications Subjects: Subjects were divided into two groups. Group (A) the patient group and group (B) the control group Study design: Case control study Sample Size: After consultation of a statistician who recommended a sample size of 60 cases for each study group. Sampling technique: Stratified sampling method, Addiction unit of psychiatric hospitals in Great Cairo has been stratified into two majo |