Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum KU Leuven, Leuven, Belgium.
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
Addiction. 2024 Feb;119(2):248-258. doi: 10.1111/add.16343. Epub 2023 Sep 27.
AIMS: To measure the independent consequences of community-level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000-2006 conflict. DESIGN: A population-representative panel study from Nepal, with precise measures of community-level violent events and subsequent individual-level AUD in males. Females were not included because of low AUD prevalence. SETTING: Chitwan, Nepal. PARTICIPANTS: Four thousand eight hundred seventy-six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15-59 were eligible (response rate 93%). MEASUREMENTS: Measures of beatings in the community during the conflict (2000-2006), including the date and distance away, were gathered through neighborhood reports, geo-location and official resources, then linked to respondents' life histories of AUD (collected in 2016-2018) using the Nepal-specific Composite International Diagnostic Interview with life history calendar. Beatings nearby predict the subsequent onset of AUD during and after the armed conflict. Data were analyzed in 2021-2022. FINDINGS: Cohort-specific, discrete-time models revealed that within the youngest cohort (born 1992-2001), those living in neighborhoods where armed conflict beatings occurred were more likely to develop AUD compared with those in other neighborhoods (odds ratio = 1.66; 95% confidence interval = 1.02-2.71). In this cohort, a multilevel matching analysis designed to simulate a randomized trial showed the post-conflict incidence of AUD for those living in neighborhoods with any armed conflict beatings was 9.5% compared with 5.3% in the matched sample with no beatings. CONCLUSIONS: Among male children living in Chitwan, Nepal during the 2000-2006 armed conflict, living in a neighborhood where armed conflict beatings occurred is associated with increased odds of developing subsequent alcohol use disorder. This association was independent of personal exposure to beatings and other mental disorders.
目的:衡量社区层面武装冲突殴打事件对尼泊尔男性在 2000-2006 年冲突期间和之后的酒精使用障碍(AUD)的独立影响。
设计:这是一项来自尼泊尔的具有代表性的人群面板研究,对男性的社区层面暴力事件和随后的个体 AUD 进行了精确测量。由于 AUD 患病率较低,因此未包括女性。
地点:尼泊尔奇特万。
参与者:来自奇特万西部 151 个街区的 4876 名男性,这些街区是通过系统选择并具有代表性的。所有年龄在 15-59 岁的居民都有资格参加(应答率为 93%)。
测量:通过社区报告、地理位置和官方资源收集冲突期间(2000-2006 年)的殴打事件,包括日期和距离,并使用具有尼泊尔特色的综合国际诊断访谈与生活史日历,将这些殴打事件与受访者的 AUD 生活史联系起来(2016-2018 年收集)。附近的殴打事件预测了武装冲突期间和之后 AUD 的随后发病。数据分析于 2021-2022 年进行。
发现:队列特定的离散时间模型显示,在最年轻的队列(1992-2001 年出生)中,与其他街区相比,生活在发生武装冲突殴打事件的街区的人更有可能患上 AUD(优势比=1.66;95%置信区间=1.02-2.71)。在这个队列中,一项旨在模拟随机试验的多级匹配分析显示,生活在有任何武装冲突殴打事件的街区的人在冲突后的 AUD 发病率为 9.5%,而在没有殴打事件的匹配样本中为 5.3%。
结论:在尼泊尔奇特万生活的 2000-2006 年武装冲突期间的男性儿童中,生活在发生武装冲突殴打事件的社区与随后发生 AUD 的几率增加有关。这种关联独立于个人遭受殴打和其他精神障碍的情况。
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