Government Medical College, Thiruvananthapuram, India.
Kerala University of Health Sciences, Thiruvananthapuram, India.
J Interpers Violence. 2020 Nov;35(23-24):5753-5771. doi: 10.1177/0886260517721896. Epub 2017 Aug 9.
High rates of suicide attempts and domestic violence (DV) in women of reproductive age group have been reported from South India, but the association between them was not studied. Hence, this study was undertaken to assess whether DV is a risk factor for attempted suicide in married women of reproductive age group. A hospital-based case-control study with 77 incident cases of attempted suicide in married women of the age group of 18 to 45 years and 153 controls belonging to the same age group, without history of suicide attempt, was undertaken over a period of 6 months. Univariate and multivariate analyses were done. The crude odds ratio (cOR) for DV was found to be 6.15 (95% confidence interval [95% CI] = [2.95, 12.82], value = .0001). Other statistically significant risk factors included younger age group (below 30 years); gross family income > Rs. 5,000; higher occupational status of spouse; having poor social support; having a family history of psychiatric disorders, substance use disorders, and suicide/suicide attempt; higher impulsiveness scores; having higher scores of stressful life events over the past 12 months, and alcohol use disorder in husband. Islamic faith was found to be a significant protective factor. On logistic regression, DV was found to be an independent risk factor for attempted suicide in this study population (adjusted OR = 3.79, 95% CI = [1.35, 10.62], value = .011). Age groups, stressful life events, impulsiveness, and alcohol use disorder in husband were the confounders adjusted for in logistic regression along with other significant risk and protective factors. Significant dose-response relationship was also observed between DV and attempted suicide. In accordance with the stress-diathesis model for suicidal behavior, DV is found to be a stressor which precipitates suicide attempt in those with diathesis like family history of psychiatric disorders. Clinical, research, and policy implications of the findings are discussed.
印度南部有报道称，育龄期妇女的自杀未遂和家庭暴力（DV）发生率较高，但两者之间的关联尚未得到研究。因此，本研究旨在评估 DV 是否是育龄已婚妇女自杀未遂的危险因素。这是一项在 6 个月内进行的基于医院的病例对照研究，共纳入 77 例 18 至 45 岁已婚女性自杀未遂病例和 153 例同年龄段无自杀未遂史的对照。进行了单变量和多变量分析。结果发现，DV 的粗比值比（cOR）为 6.15（95%置信区间[95%CI] = [2.95, 12.82]， 值=.0001）。其他具有统计学意义的危险因素包括年龄较小（<30 岁）；家庭总收入>5000 卢比；配偶的职业地位较高；社会支持较差；有精神障碍、物质使用障碍和自杀/自杀未遂家族史；冲动性得分较高；过去 12 个月经历过更多的生活压力事件；丈夫有酒精使用障碍。伊斯兰教信仰被认为是一个重要的保护因素。在逻辑回归中，DV 被发现是该研究人群自杀未遂的独立危险因素（调整后的 OR = 3.79，95%CI = [1.35, 10.62]， 值=.011）。逻辑回归中调整了年龄组、生活压力事件、冲动性和丈夫的酒精使用障碍，以及其他具有统计学意义的风险和保护因素。还观察到 DV 和自杀未遂之间存在显著的剂量反应关系。根据自杀行为的应激素质模型，DV 是一种应激源，会促使有精神障碍家族史等素质的人发生自杀未遂。讨论了研究结果的临床、研究和政策意义。
