Interpersonal violence and depression in Brazil: A cross-sectional analysis of the 2019 National Health Survey.
Interpersonal violence and depression in Brazil: A cross-sectional analysis of the 2019 National Health Survey.
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DOI：
10.1371/journal.pgph.0001207
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发表时间：
2022
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抑郁症和人际暴力是全球日益关注的公共卫生问题，特别是在低收入和中等收入国家。尽管人际暴力与抑郁症风险增加之间存在已知关系，但仍需要进一步了解经历过暴力的人的抑郁症经历，以更好地制定筛查和治疗干预措施。对2019年巴西国家健康调查的答复进行了横断面分析。抑郁症的患病率（包括临床医生诊断和患者健康问卷调查（PHQ-9）筛选）是根据过去12个月内经历的暴力类型（无，身体暴力，性暴力，身体和性暴力，或暴力威胁）估计的。Logistic回归模型评估了调整社会经济和人口因素后暴力与抑郁之间的关联。在88，531名受访者中，8.1%的人经历过任何形式的暴力。与那些没有经历过暴力的人相比，那些经历过任何类型暴力的人有更高的临床诊断或PHQ-9筛查抑郁症的患病率（例如，经历性暴力的人临床诊断抑郁症的患病率为18.8%，而没有经历暴力的人为9.5%）。未诊断和未经治疗的抑郁症在经历任何类型暴力的人中也更普遍。在逻辑回归模型中，任何暴力经历都与更高的抑郁几率相关（例如，对于PHQ-9检测到的抑郁症，aOR = 3.75（95% CI：3.06-4.59））。经历暴力也与抑郁症的可能性更高有关，这些抑郁症未被诊断（例如，在经历性暴力的人中：aOR = 3.20，95% CI 1.81-5.67）或未经治疗（例如，在经历身体和性暴力的人中：aOR = 8.06，95% CI 3.44-18.9）。这些发现强调了需要考虑在受暴力影响的人中筛查抑郁症，并优先考虑受暴力影响的社区的精神保健。
Depression and interpersonal violence are issues of increasing public health concern globally, especially in low-and-middle income countries. Despite the known relationship between interpersonal violence and an increased risk of depression, there is a need to further characterise the experience of depression in those who have experienced violence, to better develop screening and treatment interventions. A cross-sectional analysis was conducted on responses from the 2019 Brazilian National Health Survey. The prevalence of depression (both clinician-diagnosed, and Patient Health Questionnaire (PHQ-9) screened) were estimated by type of violence experienced in the preceding 12 months (none, physical violence, sexual violence, physical and sexual violence, or threat of violence). Logistic regression models assessed the associations between violence and depression after adjusting for socioeconomic and demographic factors. Of 88,531 respondents, 8.1% experienced any type of violence. Compared to those not experiencing violence, those who experienced any type of violence had a higher prevalence of clinician-diagnosed or PHQ-9-screened depression (e.g. the prevalence of clinician-diagnosed depression was 18.8% for those experiencing sexual violence compared to 9.5% for those not experiencing violence). Both undiagnosed and untreated depression were also more prevalent in those experiencing any type of violence. In logistic regression models, any experience of violence was associated with a higher odds of depression (e.g. aOR = 3.75 (95% CI: 3.06–4.59) for PHQ-9-detected depression). Experiencing violence was also associated with a higher likelihood of having depression which was undiagnosed (e.g. in those who experienced sexual violence: aOR of 3.20, 95% CI 1.81–5.67) or untreated (e.g. in those who experienced physical and sexual violence: aOR = 8.06, 95% CI 3.44–18.9). These findings highlight the need to consider screening for depression in those affected by violence, and to prioritise mental healthcare in communities affected by violence.