Adult abuse and poor prognosis in Taiwan, 2000–2015: a cohort study

BMC Public Health

Research

Pi-Ching Yu¹  Ya-Hsuan Chiang²  Chun-Hsien Chiang³  Ren-Jei Chung⁴  Shih-En Tang⁵  Shi-Hao Huang⁶  Yao-Ching Huang⁶  Iau-Jin Lin⁷  Chia-Peng Yu⁷  Wu-Chien Chien⁸  Chien-An Sun⁹  Yu-Ching Chou^1,10  Bing-Long Wang^1,10 

[1] Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Far-Eastern Memorial Hospital, 10602, New Taipei City, Taiwan;Graduate Institute of Medicine, National Defense Medical Center, 11490, Taipei, Taiwan;Cardiovascular Medicine, Far Eastern Memorial Hospital, 10602, New Taipei City, Taiwan;Department of Cardiovascular Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan;Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), 10608, Taipei, Taiwan;Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Tri‑Service General Hospital, National Defense Medical Center, 11490, Taipei, Taiwan;Institute of Aerospace and Undersea Medicine, National Defense Medical Center, 11490, Taipei, Taiwan;Department of Medical Research, Tri-Service General Hospital, 11490, Taipei, Taiwan;Department of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), 10608, Taipei, Taiwan;School of Public Health, National Defense Medical Center, 11490, Taipei, Taiwan;Department of Medical Research, Tri-Service General Hospital, 11490, Taipei, Taiwan;School of Public Health, National Defense Medical Center, 11490, Taipei, Taiwan;Department of Medical Research, Tri-Service General Hospital, 11490, Taipei, Taiwan;School of Public Health, National Defense Medical Center, 11490, Taipei, Taiwan;Graduate Institute of Life Sciences, National Defense Medical Center, 11490, Taipei, Taiwan;Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), 11490, Taipei, Taiwan;Department of Public Health, College of Medicine, Fu-Jen Catholic University, 242062, New Taipei City, Taiwan;Big Data Center, College of Medicine, Fu-Jen Catholic University, 242062, New Taipei City, Taiwan;School of Public Health, National Defense Medical Center, 11490, Taipei, Taiwan;

关键词: Adult maltreatment;    Psychotic disorders;    Schizophrenic disorders;    Suicide;    Self-inflicted injury;    Violent injury;   

DOI  :  10.1186/s12889-022-14663-y

 received in 2022-08-01, accepted in 2022-11-17,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundTo investigate the risk of poor prognosis regarding schizophrenic disorders, psychotic disorders, suicide, self-inflicted injury, and mortality after adult violence from 2000 to 2015 in Taiwan.MethodsThis study used data from National Health Insurance Research Database (NHIRD) on outpatient, emergency, and inpatient visits for two million people enrolled in the National Health Insurance (NHI) from 2000 to 2015. The case study defined ICD-9 diagnosis code N code 995.8 (abused adult) or E code E960-E969 (homicide and intentional injury of another). It analyzed first-time violence in adults aged 18–64 years (study group). 1:4 ratio was matched with injury and non-violent patients (control group). The paired variables were sex, age (± 1 year), pre-exposure to the Charlson comorbidity index, and year of medical treatment. Statistical analysis was conducted using SAS 9.4 and Cox regression for data analysis.ResultsIn total, 8,726 individuals experienced violence (case group) while34,904 did not experienced violence (control group) over 15 years. The prevalence of poor prognosis among victims of violence was 25.4/104, 31.3/104, 10.5/10,4 and 104.6/104 for schizophrenic disorders, psychotic disorders, suicide or self-inflicted injury and mortality, respectively. Among adults, the risks of suicide or self-inflicted injury, schizophrenic disorders, psychotic disorders, and mortality after exposure to violence (average 9 years) were 6.87-, 5.63-, 4.10-, and 2.50-times (p < 0.01), respectively, compared with those without violence. Among males, the risks were 5.66-, 3.85-, 3.59- and 2.51-times higher, respectively, than those without violence (p < 0.01), and they were 21.93-, 5.57-, 4.60- and 2.46-times higher than those without violence (p < 0.01) among females.ConclusionThe risk of poor prognosis regarding schizophrenic disorders, psychotic disorders, suicide, or self-inflicted injury and mortality after adult violence was higher than in those who have not experienced a violent injury. Adults at the highest risk for violent suicide or self-inflicted injuries due to exposure to violent injuries —males were at risk for schizophrenia and females were at risk for suicide or self-inflicted injuries. Therefore, it is necessary for social workers and medical personnel to pay attention to the psychological status of victims of violence.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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