Subjects were 375 participants in an ongoing 17-year longitudinal study. At age 21, nearly 11 percent reported physical or sexual abuse before age 18. Psychiatric disorders based on DSM-III-R criteria were assessed using the National Institute of Mental Health Diagnostic Interview Schedule, Revised Version (DIS-III-R). Approximately 80 percent of the abused young adults met DSM-III-R criteria for at least one psychiatric disorder at age 21. Compared to their nonabused counterparts, abused subjects demonstrated significant impairments in functioning at both ages 15 and 21, including more depressive symptomatology, anxiety, psychiatric disorders, emotional- behavioral problems, suicidal ideation, and suicide attempts. Although abused individuals were functioning significantly more poorly overall at ages 15 and 21 than their nonabused peers, gender differences and distinct patterns of impaired functioning emerged. These deficits underscore the need for early intervention and prevention strategies to forestall or minimize the serious consequences of child abuse. 6 tables and 36 references