The purpose of the present study was to examine the relationship between childhood and adolescent physical and sexual abuse before the age of 18 and psychosocial functioning in mid-adolescence (age 15) and early adulthood (age 21) in a representative community sample of young adults. Subjects were 375 participants in an ongoing 17-years longitudinal study. At age 21, nearly 11% reported physical or sexual abuse before age 18. Psychiatric disorders based on DSM-III-R criteria were assessed utilizing the NIMH Diagnostic Interview Schedule, Revised Version (DIS-III-R). Approximately 80% 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 both at ages 15 and at 21, including more depressive symptomatology, anxiety, psychiatric disorders, emotional-behavioral problems, suicidal ideation, and suicide attempts. While 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.