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全国共病调查复制研究中无机构收容的携带武器者所造成的精神障碍及威胁

Mental disorder and threats made by noninstitutionalized people with weapons in the national comorbidity survey replication.

作者信息

Casiano Hygiea, Belik Shay-Lee, Cox Brian J, Waldman Jeffrey C, Sareen Jitender

机构信息

Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.

出版信息

J Nerv Ment Dis. 2008 Jun;196(6):437-45. doi: 10.1097/NMD.0b013e3181775a2a.

Abstract

Controversy exists as to whether mental disorders are associated with a higher risk of violent behavior. Data from the nationally-representative National Comorbidity Survey Replication was examined. Multiple logistic regression was used to determine whether mood, anxiety, impulse control, and substance use disorders were associated with a higher rate of potentially violent behavior as assessed by threatening others with a gun or other weapon. After adjusting for sociodemographic factors, an association was found between mood, anxiety, impulse control, and substance use disorders and the rate of threatening others. A significant association was found between threats made against others with a gun and both substance use disorders (adjusted odds ratio [AOR] 2.27; 95% confidence interval [CI] 1.62-3.20) and impulse control disorders (AOR 2.67; 95% CI 1.95-3.66). Threats made against others with any other type of weapon were significantly associated with any anxiety (AOR 1.76; 95% CI 1.34-2.31), substance (AOR 2.63; 95% CI 1.87-3.71), or impulse control disorder (AOR 2.49; 95% CI 1.96-3.18). Of the disorders studied, social phobia, specific phobia, and impulse control disorders seemed to have their onset before the act of threatening others with weapons. This finding was also true for those who had attempted suicide. Further research is needed to determine whether treatment of mental disorders decreases the risk of violence in this population.

摘要

关于精神障碍是否与暴力行为的较高风险相关存在争议。对具有全国代表性的全国共病调查复制研究的数据进行了检查。使用多元逻辑回归来确定情绪、焦虑、冲动控制和物质使用障碍是否与通过用枪或其他武器威胁他人评估的潜在暴力行为的较高发生率相关。在调整社会人口学因素后,发现情绪、焦虑、冲动控制和物质使用障碍与威胁他人的发生率之间存在关联。发现用枪威胁他人与物质使用障碍(调整后的优势比[AOR] 2.27;95%置信区间[CI] 1.62 - 3.20)和冲动控制障碍(AOR 2.67;95% CI 1.95 - 3.66)均存在显著关联。用任何其他类型武器威胁他人与任何焦虑障碍(AOR 1.76;95% CI 1.34 - 2.31)、物质使用障碍(AOR 2.63;95% CI 1.87 - 3.71)或冲动控制障碍(AOR 2.49;95% CI 1.96 - 3.18)均存在显著关联。在所研究的障碍中,社交恐惧症、特定恐惧症和冲动控制障碍似乎在使用武器威胁他人的行为之前就已发病。对于那些曾试图自杀的人来说,这一发现同样成立。需要进一步研究以确定精神障碍的治疗是否会降低该人群中的暴力风险。

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