{"title":"撒哈拉以南非洲妇女受害者-幸存者的性暴力与精神障碍之间的关系：系统回顾和荟萃分析。","authors":"Sintayehu Abebe Woldie, Genevieve Walker, Sarah Bergman, Kristin Diemer, Karen Block, Gregory Armstrong, Mirgissa Kaba, Cathy Vaughan","doi":"10.1136/bmjgh-2024-017962","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sexual violence is a serious public health and human rights problem with both short-term and long-term consequences. This review aims to systematically assess the link between sexual violence and poor mental health among sub-Saharan African women.</p><p><strong>Methods: </strong>Systematic review and meta-analyses of observational studies were performed. MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane, Global Health and the University of Melbourne library electronic databases were used to find relevant published literature over 12 years from 2012 to 2024 in sub-Saharan Africa with stringent eligibility criteria. Random effects meta-analyses were used to pool estimates of ORs and 95% CIs. The I<sup>2</sup> statistic was used to assess heterogeneity.</p><p><strong>Results: </strong>This systematic review and meta-analysis of 76 observational studies included a total of 80 313 participants and found a consistent small-to-medium association between lifetime sexual violence and experiences of poor mental health. The pooled ORs suggest that women who were exposed to sexual violence were more than twice as likely to experience post-traumatic stress disorder (OR 2.75; 95% CI 1.96 to 3.86; I<sup>2</sup>=73.4%), depression (OR 2.38; 95% CI 2.04 to 2.77; I<sup>2</sup>=56.6%), anxiety (OR 2.81; 95% CI 1.67 to 4.72; I<sup>2</sup>=77.2%), common mental disorders (OR 2.12; 95% CI 1.70 to 2.64; I<sup>2</sup>=0.0%), suicidal behaviour (OR 2.44; 95% CI 1.92 to 3.10; I<sup>2</sup>=68.0%) and emotional distress (OR 3.14; 95% CI 1.73 to 5.69; I<sup>2</sup>=79.6%) compared with women who have not experienced sexual violence.</p><p><strong>Conclusions: </strong>Exposure to lifetime sexual violence was consistently associated with small to medium effects on poor mental health among women in sub-Saharan Africa. Thus, policy-makers should develop response strategies as well as mental health screening tools for all violence response service delivery points. In addition, health practitioners must prioritise screening for mental health conditions in patients who present with a history of sexual violence.</p>","PeriodicalId":9137,"journal":{"name":"BMJ Global Health","volume":"10 3","pages":""},"PeriodicalIF":7.1000,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931965/pdf/","citationCount":"0","resultStr":"{\"title\":\"The association between sexual violence and mental disorders among women victim-survivors in sub-Saharan Africa: a systematic review and meta-analysis.\",\"authors\":\"Sintayehu Abebe Woldie, Genevieve Walker, Sarah Bergman, Kristin Diemer, Karen Block, Gregory Armstrong, Mirgissa Kaba, Cathy Vaughan\",\"doi\":\"10.1136/bmjgh-2024-017962\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sexual violence is a serious public health and human rights problem with both short-term and long-term consequences. This review aims to systematically assess the link between sexual violence and poor mental health among sub-Saharan African women.</p><p><strong>Methods: </strong>Systematic review and meta-analyses of observational studies were performed. MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane, Global Health and the University of Melbourne library electronic databases were used to find relevant published literature over 12 years from 2012 to 2024 in sub-Saharan Africa with stringent eligibility criteria. Random effects meta-analyses were used to pool estimates of ORs and 95% CIs. The I<sup>2</sup> statistic was used to assess heterogeneity.</p><p><strong>Results: </strong>This systematic review and meta-analysis of 76 observational studies included a total of 80 313 participants and found a consistent small-to-medium association between lifetime sexual violence and experiences of poor mental health. The pooled ORs suggest that women who were exposed to sexual violence were more than twice as likely to experience post-traumatic stress disorder (OR 2.75; 95% CI 1.96 to 3.86; I<sup>2</sup>=73.4%), depression (OR 2.38; 95% CI 2.04 to 2.77; I<sup>2</sup>=56.6%), anxiety (OR 2.81; 95% CI 1.67 to 4.72; I<sup>2</sup>=77.2%), common mental disorders (OR 2.12; 95% CI 1.70 to 2.64; I<sup>2</sup>=0.0%), suicidal behaviour (OR 2.44; 95% CI 1.92 to 3.10; I<sup>2</sup>=68.0%) and emotional distress (OR 3.14; 95% CI 1.73 to 5.69; I<sup>2</sup>=79.6%) compared with women who have not experienced sexual violence.</p><p><strong>Conclusions: </strong>Exposure to lifetime sexual violence was consistently associated with small to medium effects on poor mental health among women in sub-Saharan Africa. Thus, policy-makers should develop response strategies as well as mental health screening tools for all violence response service delivery points. 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引用次数: 0
摘要
背景：性暴力是一个严重的公共卫生和人权问题，既有短期后果，也有长期后果。这项审查旨在系统地评估撒哈拉以南非洲妇女的性暴力与精神健康状况不佳之间的联系。方法：对观察性研究进行系统回顾和荟萃分析。采用MEDLINE、CINAHL、EMBASE、PsycINFO、Cochrane、Global Health和墨尔本大学图书馆电子数据库查找撒哈拉以南非洲地区2012 - 2024年12年间的相关已发表文献，并采用严格的入选标准。随机效应荟萃分析用于汇总ORs和95% ci的估计。I2统计量用于评估异质性。结果：这项对76项观察性研究的系统回顾和荟萃分析，共包括80313名参与者，发现终生性暴力与精神健康状况不佳之间存在一致的中小型关联。汇总后的ORs表明，遭受过性暴力的女性患创伤后应激障碍的可能性是其他女性的两倍多(OR 2.75；95% CI 1.96 ~ 3.86；I2=73.4%)、抑郁(OR 2.38；95% CI 2.04 ~ 2.77；I2=56.6%)、焦虑(OR 2.81；95% CI 1.67 ~ 4.72；I2=77.2%)，常见精神障碍(OR 2.12；95% CI 1.70 ~ 2.64；I2=0.0%)、自杀行为(OR 2.44；95% CI 1.92 ~ 3.10；I2=68.0%)和情绪困扰(OR 3.14；95% CI 1.73 ~ 5.69；I2=79.6%)，与没有经历过性暴力的女性相比。结论：终生遭受性暴力始终与撒哈拉以南非洲妇女心理健康状况不佳的小到中等影响有关。因此，决策者应该为所有暴力应对服务提供点制定应对战略和心理健康筛查工具。此外，卫生从业人员必须优先筛查有过性暴力史的患者的精神健康状况。
The association between sexual violence and mental disorders among women victim-survivors in sub-Saharan Africa: a systematic review and meta-analysis.
Background: Sexual violence is a serious public health and human rights problem with both short-term and long-term consequences. This review aims to systematically assess the link between sexual violence and poor mental health among sub-Saharan African women.
Methods: Systematic review and meta-analyses of observational studies were performed. MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane, Global Health and the University of Melbourne library electronic databases were used to find relevant published literature over 12 years from 2012 to 2024 in sub-Saharan Africa with stringent eligibility criteria. Random effects meta-analyses were used to pool estimates of ORs and 95% CIs. The I2 statistic was used to assess heterogeneity.
Results: This systematic review and meta-analysis of 76 observational studies included a total of 80 313 participants and found a consistent small-to-medium association between lifetime sexual violence and experiences of poor mental health. The pooled ORs suggest that women who were exposed to sexual violence were more than twice as likely to experience post-traumatic stress disorder (OR 2.75; 95% CI 1.96 to 3.86; I2=73.4%), depression (OR 2.38; 95% CI 2.04 to 2.77; I2=56.6%), anxiety (OR 2.81; 95% CI 1.67 to 4.72; I2=77.2%), common mental disorders (OR 2.12; 95% CI 1.70 to 2.64; I2=0.0%), suicidal behaviour (OR 2.44; 95% CI 1.92 to 3.10; I2=68.0%) and emotional distress (OR 3.14; 95% CI 1.73 to 5.69; I2=79.6%) compared with women who have not experienced sexual violence.
Conclusions: Exposure to lifetime sexual violence was consistently associated with small to medium effects on poor mental health among women in sub-Saharan Africa. Thus, policy-makers should develop response strategies as well as mental health screening tools for all violence response service delivery points. In addition, health practitioners must prioritise screening for mental health conditions in patients who present with a history of sexual violence.
期刊介绍：
BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.
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