遭受暴力伤害前后的精神障碍:一项基于挪威全国登记册的队列研究

IF 3.7 2区 医学 Q1 PSYCHIATRY
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引用次数: 0

摘要

人与人之间的暴力伤害与随后出现心理问题的风险增加有关,但之前存在的精神病理学可能会使这种关联复杂化,而人们对这种复杂化的方式知之甚少。我们利用挪威的全国性纵向登记数据,检验了精神病史如何改变暴力伤害与后续精神障碍之间的关联,并考察了暴力伤害前后精神障碍的持续性。我们确定了 2010-2018 年期间因暴力伤害而到急诊室就诊的所有患者,以及与之性别和年龄相匹配的普通人群。主要结果是观察到 2018 年 12 月 31 日的后续精神障碍,次要分析是检查受伤前与受伤后的精神诊断。在28276名暴力伤害患者中,20%有精神病史,而在282760名对比人群中,只有6%有精神病史。在 Cox 回归模型中,与匹配的同龄人相比,暴力受伤患者罹患任何后续精神障碍的比例要高得多(HRadj:2.36;95% CI:2.29,2.42),但这种关联受到精神病史的干扰和影响。受暴力伤害的患者在受伤前后接受精神病诊断的连续性很高,但他们也比配对组更有可能接受新的诊断,这可能表明新的精神障碍的发生与暴力暴露有关。受暴力伤害的患者面临着巨大的精神障碍负担,尤其是药物使用和情绪/焦虑障碍;需要制定临床和公共卫生策略来解决这一负担,在某些情况下,这种负担发生在暴力伤害之前,但在另一些情况下,很可能是由暴力伤害引起的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychiatric disorder before and after exposure to violent injury: A nationwide Norwegian register-based cohort study
Interpersonal violent injury is associated with increased risk of subsequent psychological problems, but pre-existing psychopathology may complicate this association in ways that are poorly understood. Using nationwide longitudinal registry data from Norway, we tested how psychiatric history modified the association between violent injury exposure and subsequent psychiatric disorder, and examined disorder continuity before vs. after violent injury. We identified all individuals presenting to emergency services in 2010–2018 with a violent injury, along with sex- and age-matched comparison individuals from the general population. The primary outcome was subsequent psychiatric disorder, observed through December 31, 2018, with secondary analyses examining psychiatric diagnoses pre- vs. post-injury. Of the 28,276 violence-injured patients, 20% had a history of psychiatric disorder, vs. 6% of the 282,760 comparison individuals. In Cox regression models, violence-injured patients had substantially higher rates of any subsequent psychiatric disorder when compared to matched peers (HRadj: 2.36; 95% CI: 2.29, 2.42), but this association was confounded and modified by psychiatric history. Continuity of psychiatric diagnosis before and after injury was high among violence-injured patients, but they were also more likely than the comparison group to receive a new diagnosis, potentially indicating incident onset of new psychiatric disorder associated with violence exposure. Violence-injured patients face substantial burden of psychiatric disorder, especially for substance use and mood/anxiety disorders; clinical and public health strategies are needed to address this burden, which precedes violent injury in some cases but is likely provoked by it in others.
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来源期刊
Journal of psychiatric research
Journal of psychiatric research 医学-精神病学
CiteScore
7.30
自引率
2.10%
发文量
622
审稿时长
130 days
期刊介绍: Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;
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