Ribeiro Wagner S, Andreoli Sergio B, Ferri Cleusa P, Prince Martin, Mari Jair Jesus
Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Braz J Psychiatry. 2009 Oct;31 Suppl 2:S49-57. doi: 10.1590/s1516-44462009000600003.
To study the epidemiological evidence on the prevalence of exposure to violence and its relationship with mental health problems in low and middle-income countries.
The search was based on cross-sectional and cohort studies available in electronic databases (Medline, Psycinfo, Embase, SciELO and Lilacs), through July 2009, using the key words: 'violence' and 'mental disorders'.
The frequency of exposure to violence was shown to be very high and was significantly associated with mental health problems. Among children, the highest correlation was found to be of domestic violence with externalizing problems (OR = 9.5; 95% CI = 3.4-26.2), and suicidal ideation with sexual abuse (OR = 8.3; p < 0.05); among women, depression/anxiety symptoms correlated with intimate-partner psychological (OR = 3.2; 95% CI = 1.8-5.8) and sexual (OR = 9.7; 95% CI = 1.9-51.2) violence. In the general population, the highest prevalence rates of post-traumatic stress disorder were associated with sexual and domestic violence, kidnapping, and cumulative trauma exposure. Violence also correlated with common mental disorders.
A substantial part of the mental health problems in low and middle-income countries can be attributed to violence. Thus, interventions directed to decrease violence in low and middle-income countries might have a major positive impact on the mental health of those living in these settings.
研究中低收入国家暴力暴露患病率及其与心理健康问题关系的流行病学证据。
检索截至2009年7月电子数据库（Medline、Psycinfo、Embase、SciELO和Lilacs）中可用的横断面研究和队列研究，使用关键词：“暴力”和“精神障碍”。
暴力暴露频率显示非常高，且与心理健康问题显著相关。在儿童中，发现家庭暴力与外化问题的相关性最高（OR = 9.5；95% CI = 3.4 - 26.2），性虐待与自杀意念的相关性最高（OR = 8.3；p < 0.05）；在女性中，抑郁/焦虑症状与亲密伴侣心理暴力（OR = 3.2；95% CI = 1.8 - 5.8）和性暴力（OR = 9.7；95% CI = 1.9 - 51.2）相关。在一般人群中，创伤后应激障碍的最高患病率与性暴力、家庭暴力、绑架和累积创伤暴露相关。暴力也与常见精神障碍相关。
中低收入国家的很大一部分心理健康问题可归因于暴力。因此，针对减少中低收入国家暴力的干预措施可能会对生活在这些环境中的人们的心理健康产生重大积极影响。
