Morgan Vera A, Morgan Frank, Galletly Cherrie, Valuri Giulietta, Shah Sonal, Jablensky Assen
Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.
Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2016 Feb;51(2):269-79. doi: 10.1007/s00127-015-1155-6. Epub 2015 Nov 18.
Our aim was to establish the 12-month prevalence of violent victimisation in a large sample of adults with psychotic disorders (N = 1825), compare this to population estimates, and examine correlates of violent victimisation.
The Australian national psychosis survey used a two-phase design to draw a representative sample of adults aged 18-64 years with psychotic disorders. Interview questions included psychopathology, cognition, sociodemographics, substance use, criminality, and childhood and adult victimisation. Multivariable logistic regression models were used to examine the independent contributions of known risk factors, clinical profile and childhood abuse, on risk of violent victimisation. Differences between men and women were examined.
Among adults with psychotic disorders, 12-month prevalence of any victimisation was 38.6% (males 37.4%, females 40.5%), and of violent victimisation was 16.4% (males 15.2%; females 18.3%). Violent victimisation was 4.8 times higher than the population rate of 3.4% (6.5 times higher for women; 3.7 times higher for men). Significant correlates of violent victimisation were established sociodemographic and behavioural risk factors predicting victimisation in the general community: younger age, residence in the most disadvantaged neighbourhoods, homelessness, lifetime alcohol abuse/dependence, and prior criminal offending. Among clinical variables, only mania and self-harm remained significant in the multivariable model. Childhood abuse was independently associated with violent victimisation.
Rates of violent victimisation are high for people with psychotic disorders, especially women, compared to population rates. Greater exposure to sociodemographic and behavioural risks may render them particularly vulnerable to victimisation. Social cognition as a valuable treatment target is discussed.
我们的目标是确定一大群患有精神障碍的成年人(N = 1825)中暴力受害情况的12个月患病率,将其与总体估计值进行比较,并研究暴力受害情况的相关因素。
澳大利亚全国精神病调查采用两阶段设计,以抽取18 - 64岁患有精神障碍的成年人的代表性样本。访谈问题包括精神病理学、认知、社会人口统计学、物质使用、犯罪情况以及童年和成年期的受害经历。多变量逻辑回归模型用于检验已知风险因素、临床特征和童年期虐待对暴力受害风险的独立影响。同时对男性和女性之间的差异进行了研究。
在患有精神障碍的成年人中,任何形式受害情况的12个月患病率为38.6%(男性为37.4%,女性为40.5%),暴力受害情况的患病率为16.4%(男性为15.2%;女性为18.3%)。暴力受害率比总体比率3.4%高出4.8倍(女性高出6.5倍;男性高出3.7倍)。暴力受害情况的显著相关因素包括在普通人群中预测受害情况的既定社会人口统计学和行为风险因素:年龄较小、居住在最贫困社区、无家可归、终生酒精滥用/依赖以及先前有犯罪记录。在临床变量中,多变量模型中仅躁狂和自我伤害仍具有显著性。童年期虐待与暴力受害情况独立相关。
与总体比率相比,患有精神障碍的人群,尤其是女性,暴力受害率较高。更多地暴露于社会人口统计学和行为风险中可能使他们特别容易受到伤害。文中讨论了将社会认知作为一个有价值的治疗靶点。