Rees Susan, Steel Zachary, Creamer Mark, Teesson Maree, Bryant Richard, McFarlane Alexander C, Mills Katherine L, Slade Tim, Carragher Natacha, O'Donnell Meaghan, Forbes David, Silove Derrick
BMC Psychiatry. 2014 Nov 18;14:312. doi: 10.1186/s12888-014-0312-x.
Women exposed to gender-based violence (GBV) experience a high rate of common mental disorders and suicidal behaviour ("mental disturbance"). Little is known however about the timing of onset of mental disturbance following first exposure to GBV amongst women with no prior mental disorder.
The analysis was undertaken on the Australian National Mental Health and Wellbeing Survey dataset (N = 8841). We assessed lifetime prevalence and first onset of common mental disorder and suicidal behaviour (mental disturbance) and exposure to GBV and its first occurrence based on the Composite International Diagnostic Interview Version 3 (WMH-CIDI 3.0). We used the Kaplan-Meier method to derive cumulative incident curves for first onset mental disturbance. The two derived subgroups were women who experienced GBV without prior mental disturbance; and women never exposed to GBV stratified to match the former group on age and socio-economic status.
For women with no prior mental disorder, the cumulative incidence curves showed a high incidence of all mental disturbances following first GBV, compared to women without exposure to GBV (all log rank tests <0.0001). Nearly two fifths (37%) of any lifetime mental disturbance had onset in the year following first GBV in women exposed to abuse. For these women, over half (57%) of cases of lifetime PTSD had onset in the same time interval. For GBV exposed women, half of all cases of mental disturbance (54%) and two thirds of cases of PTSD (66.9%) had onset in the five years following first abuse. In contrast, there was a low prevalence of onset of mental disturbance in the comparable imputed time to event period for women never exposed to GBV (for any mental disturbance, 1% in the first year, 12% in five years; for PTSD 3% in the first year, 7% in five years).
Amongst women without prior mental disturbance, common mental disorders and suicidal behaviour have a high rate of onset in the one and five year intervals following exposure to GBV. There is a particularly high incidence of PTSD in the first year following GBV.
遭受基于性别的暴力（GBV）的女性患常见精神障碍和自杀行为（“精神障碍”）的比例很高。然而，对于首次遭受GBV且此前无精神障碍的女性，精神障碍发病的时间却知之甚少。
分析采用澳大利亚全国心理健康与幸福调查数据集（N = 8841）。我们根据综合国际诊断访谈第3版（WMH - CIDI 3.0）评估了常见精神障碍和自杀行为（精神障碍）的终生患病率和首次发病情况，以及GBV暴露情况及其首次发生时间。我们使用Kaplan - Meier方法得出首次发病精神障碍的累积发病曲线。得出的两个亚组分别是：此前无精神障碍但遭受GBV的女性；以及从未遭受GBV且在年龄和社会经济地位上与前一组匹配的女性。
对于此前无精神障碍的女性，与未遭受GBV的女性相比，累积发病曲线显示首次遭受GBV后所有精神障碍的发病率都很高（所有对数秩检验<0.0001）。在遭受虐待的女性中，近五分之二（37%）的终生精神障碍在首次遭受GBV后的一年内发病。对于这些女性，超过一半（57%）的终生创伤后应激障碍（PTSD）病例在同一时间间隔内发病。对于遭受GBV的女性，所有精神障碍病例的一半（54%）和三分之二的PTSD病例（66.9%）在首次遭受虐待后的五年内发病。相比之下，在从未遭受GBV的女性的可比事件发生时间推算期内，精神障碍发病的患病率较低（对于任何精神障碍，第一年为1%，五年内为12%；对于PTSD，第一年为3%，五年内为7%）。
在此前无精神障碍的女性中，常见精神障碍和自杀行为在遭受GBV后的一年和五年内发病率很高。GBV后的第一年PTSD发病率尤其高。
