Division of Epidemiology & Biostatistics, University of California, Berkeley School of Public Health, Berkeley, CA, USA.
Division of Epidemiology & Biostatistics, University of California, Berkeley School of Public Health, Berkeley, CA, USA.
Prev Med. 2019 Apr;121:136-140. doi: 10.1016/j.ypmed.2019.01.003. Epub 2019 Feb 10.
Police use of force is an important public health issue in the US. Recent high-profile incidents suggest a potential link between mental disorders and police use of force, however little research has examined their co-occurrence in the general population. We aimed to assess the overall association between specific mental and substance use disorders (MSUDs) and nonfatal legal intervention injury. We identified nonfatal legal intervention injury cases (n = 90,099) and MSUD diagnoses from all hospital and emergency department (ED) records in California between 2005 and 2014. Age-, sex-, and race-standardized MSUD prevalence estimates among legal intervention injury cases, stratified by inpatient status, were compared to general US population-based estimates from the National Comorbidity Survey Replication. Compared to the general US population, nonaffective psychoses, mood disorders, alcohol use disorders, and drug use disorders were substantially overrepresented among inpatient legal intervention injuries (prevalence difference [PD]: 19.2%, (95% confidence interval [CI]: 18.0, 20.4); PD: 15.3%, (95% CI: 13.9, 16.7); PD: 21.1%, (95% CI: 19.8, 22.4); PD: 29.7%, (95% CI: 28.4, 31.0), respectively). Associations for all except mood disorders were similar but attenuated among ED injury cases. In contrast, anxiety disorders were underrepresented in both inpatient and ED injury cases. Results for mood disorders and suicidal ideation were mixed. In summary, MSUDs characterized by more overt behavioral symptoms were substantially overrepresented among legal intervention injury cases. Findings support the potential importance of interventions to improve treatment and law enforcement recognition of such disorders. Additional research should disentangle the complex relationship between MSUDs and legal intervention injury.
警察使用武力在美国是一个重要的公共卫生问题。最近一些备受瞩目的事件表明，精神障碍与警察使用武力之间可能存在潜在联系，但很少有研究在普通人群中检查它们的共同发生。我们旨在评估特定的精神和物质使用障碍（MSUDs）与非致命法律干预伤害之间的总体关联。我们从 2005 年至 2014 年期间加利福尼亚州所有医院和急诊部（ED）记录中确定了非致命法律干预伤害病例（n=90099）和 MSUD 诊断。根据住院状态，将法律干预伤害病例中的 MSUD 患病率估计值与全国共病调查复制的一般美国人口基础估计值进行年龄、性别和种族标准化比较。与一般美国人群相比，非情感性精神病、心境障碍、酒精使用障碍和药物使用障碍在住院法律干预伤害中明显过多（患病率差异[PD]：19.2%，（95%置信区间[CI]：18.0，20.4）；PD：15.3%，（95% CI：13.9，16.7）；PD：21.1%，（95% CI：19.8，22.4）；PD：29.7%，（95% CI：28.4，31.0））。ED 伤害病例的所有关联（除心境障碍外）相似，但均减弱。相比之下，焦虑障碍在住院和 ED 伤害病例中均不足。心境障碍和自杀意念的结果好坏参半。总之，具有更明显行为症状的 MSUD 明显过多地出现在法律干预伤害病例中。研究结果支持采取干预措施改善此类障碍的治疗和执法认可的重要性。应开展更多研究以阐明 MSUDs 与法律干预伤害之间的复杂关系。
