Gould D A, Stevens N G, Ward N G, Carlin A S, Sowell H E, Gustafson B
Department of Family Medicine, University of Washington School of Medicine, Seattle.
Arch Fam Med. 1994 Mar;3(3):252-6. doi: 10.1001/archfami.3.3.252.
To describe the prevalence of childhood physical, sexual, and emotional abuse and suicide attempts in a sample of adult patients from a primary care setting and to examine the relationship between suicide attempts and a self-reported history of childhood abuse.
Cross-sectional sampling via a self-administered survey that included an abuse questionnaire, the Inventory to Diagnose Depression, and questions regarding suicide.
University medical center family medicine practice.
A convenience sample of patients aged 18 years and older presenting for care. Of the 778 patients approached, 448 patients (58%) consented and returned their surveys. We report only on the 292 surveys (38%) returned with complete information. Subjects were predominantly middle class and white, with a mean age of 37 years.
Forty-four percent of the patients reported experience of childhood abuse, and 22% reported multiple forms of abuse. Eighteen percent of abused vs 3% of nonabused patients (P = .00001) reported a history of suicide attempts. Being female, younger, and less educated were associated with any abuse. Females reported more sexual abuse; less educated patients, more physical abuse; and younger patients, more physical and sexual abuse and suicide attempts. Odds ratios for suicide attempts, when adjusted by abuse status, were 6.4 for any abuse (95% confidence intervals [CI], 2.4 to 17.6), 4.1 for sexual abuse (95% CI, 1.7 to 9.9), 3.7 for emotional abuse (95% CI, 1.4 to 10.0), and 1.2 for physical abuse (95% CI, 0.5 to 3.1).
A history of childhood abuse was a common experience in this sample. Patients with a history of abuse, particularly sexual and emotional abuse, are at increased risk of suicidal behavior. To facilitate more appropriate care and treatment, primary care practitioners should question patients regarding a history of abuse.
描述来自初级保健机构的成年患者样本中儿童期身体虐待、性虐待、情感虐待及自杀未遂的发生率，并研究自杀未遂与自我报告的儿童期虐待史之间的关系。
通过自我管理的调查问卷进行横断面抽样，该问卷包括一份虐待调查问卷、抑郁诊断量表以及有关自杀的问题。
大学医学中心家庭医学诊所。
前来就诊的18岁及以上患者的便利样本。在778名被邀请的患者中，448名患者（58%）同意并返回了调查问卷。我们仅报告了292份（38%）提供完整信息的返回调查问卷。受试者主要为中产阶级白人，平均年龄37岁。
44%的患者报告有儿童期虐待经历，22%报告有多种形式的虐待。18%的受虐患者与3%的未受虐患者报告有自杀未遂史（P = 0.00001）。女性、年轻及受教育程度较低与任何形式的虐待相关。女性报告更多的性虐待；受教育程度较低的患者报告更多的身体虐待；年轻患者报告更多的身体和性虐待以及自杀未遂。根据虐待状况进行调整后，自杀未遂的比值比为：任何形式的虐待为6.4（95%置信区间[CI]，2.4至17.6），性虐待为4.1（95%CI，1.7至9.9），情感虐待为3.7（95%CI，1.4至10.0），身体虐待为1.2（95%CI，0.5至3.1）。
儿童期虐待史在该样本中是一种常见经历。有虐待史的患者，尤其是性虐待和情感虐待患者，自杀行为风险增加。为了促进更恰当的护理和治疗，初级保健医生应询问患者的虐待史。
