Violence against women is strongly associated with suicide attempts: Evidence from the WHO multi-country study on women's health and domestic violence against women
Violence against women is strongly associated with suicide attempts: Evidence from the WHO multi-country study on women's health and domestic violence against women
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DOI：
10.1016/j.socscimed.2011.05.006
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发表时间：
2011-07-01
影响因子：
5.4
通讯作者：
Garcia-Moreno, Claudia
中科院分区：
文献类型：
--
作者：
Devries, Karen;Watts, Charlotte;Garcia-Moreno, Claudia
自杀行为是造成全球妇女疾病负担的最重要因素之一，但对低收入和中等收入国家的流行率和可改变的风险因素知之甚少。我们使用世卫组织关于妇女健康和对妇女的家庭暴力的多国研究的数据，研究自杀想法和企图的流行率，以及自杀企图与心理健康状况、儿童性虐待、伴侣暴力和其他变量之间的关系。2000-2003年，在巴西、埃塞俄比亚、日本、纳米比亚、秘鲁、萨摩亚、塞尔维亚、泰国和坦桑尼亚的13个省（更多是农村）和市（城市）地点进行了具有代表性的人口横断面住户调查。20 967名年龄在15-49岁之间的妇女参加了培训。计算了过去四周内终生自杀企图、终生自杀想法和自杀想法的患病率，并拟合多变量logistic回归模型，以检查每个研究中心与自杀企图相关的因素。终生自杀企图的患病率范围为0.8%（坦桑尼亚）至12.0%（秘鲁城市）;终生自杀念头的患病率范围为7.2%（坦桑尼亚省）至29.0%（秘鲁省），过去四周内自杀念头的患病率范围为1.9%（塞尔维亚）至13.6%（秘鲁省）。在过去四周内有自杀念头的妇女中，有25-50%在此期间也曾去看过卫生工作者。在调整可能的常见心理健康障碍后，自杀未遂最一致的风险因素是：亲密伴侣暴力、非伴侣身体暴力、曾经离婚、分居或丧偶、童年性虐待以及母亲经历过亲密伴侣暴力。心理健康政策和服务必须认识到低收入和中等收入国家妇女暴力和自杀之间的一致关系。培训卫生部门工作人员认识和应对暴力的后果，可以大大减少与自杀行为有关的健康负担。(C)2011爱思唯尔有限公司保留所有权利。
Suicidal behaviours are one of the most important contributors to the global burden of disease among women, but little is known about prevalence and modifiable risk factors in low and middle income countries. We use data from the WHO multi-country study on women's health and domestic violence against women to examine the prevalence of suicidal thoughts and attempts, and relationships between suicide attempts and mental health status, child sexual abuse, partner violence and other variables. Population representative cross-sectional household surveys were conducted from 2000-2003 in 13 provincial (more rural) and city (urban) sites in Brazil, Ethiopia, japan, Namibia, Peru, Samoa, Serbia, Thailand and Tanzania. 20967 women aged 15-49 years participated. Prevalence of lifetime suicide attempts, lifetime suicidal thoughts, and suicidal thoughts in the past four weeks were calculated, and multivariate logistic regression models were fit to examine factors associated with suicide attempts in each site. Prevalence of lifetime suicide attempts ranged from 0.8% (Tanzania) to 12.0% (Peru city): lifetime thoughts of suicide from 7.2% (Tanzania province) to 29.0% (Peru province), and thoughts in the past four weeks from 1.9% (Serbia) to 13.6% (Peru province). 25-50% of women with suicidal thoughts in the past four weeks had also visited a health worker in that time. The most consistent risk factors for suicide attempts after adjusting for probable common mental health disorders were: intimate partner violence, non-partner physical violence, ever being divorced, separated or widowed, childhood sexual abuse and having a mother who had experienced intimate partner violence. Mental health policies and services must recognise the consistent relationship between violence and suicidality in women in low and middle income countries. Training health sector workers to recognize and respond to the consequences of violence may substantially reduce the health burden associated with suicidal behaviour. (C) 2011 Elsevier Ltd. All rights reserved.