社区暴露于武装冲突和随后出现的酒精使用障碍
Ronny Bruffaerts1, William G Axinn2, Dirgha J Ghimire2
1Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum KU Leuven, Leuven, Belgium.
Addiction (Abingdon, England)
|September 27, 2023
概括
在尼泊尔冲突期间的社区暴力增加了年轻男性的酒精使用障碍 (AUD) 风险. 邻居殴打,而不是个人伤害,预测了AUD发病,突出了集体创伤对公共健康的影响.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 创伤研究 创伤研究
背景情况:
- 尼泊尔从2000年至2006年经历了长达十年的武装冲突.
- 在此期间,社区层面的暴力,包括殴打,普遍存在.
- 酒精使用障碍 (AUD) 是一个重要的公共卫生问题,可能会被冲突相关的压力加剧.
研究的目的:
- 调查社区级武装冲突殴打对男性AUD发展的独立影响.
- 为了区分目击或经历社区暴力的影响与直接的个人接触.
- 分析尼泊尔冲突期间和之后的AUD发病率.
主要方法:
- 在尼泊尔的Chitwan进行了一项人口代表小组研究.
- 数据包括社区一级暴力事件的精确测量和男性 (15-59岁) 个人一级AUD诊断.
- 使用尼泊尔特定的复合国际诊断面试与生命史日历,与地理位置的冲突数据联系在一起,收集了AUD的生命史.
主要成果:
- 在武装冲突中遭受殴打的社区生活与最年轻的队列 (1992-2001年出生) 中患AUD的可能性更高.
- 在这个队列中,AUD发病的几率比为1.66 (95% CI:1.02-2.71).
- 多层匹配分析表明,与未暴露 (5.3%) 相比,暴露社区的AUD发病率更高 (9.5%).
结论:
- 社区级武装冲突中的殴打独立预测男性随后出现的酒精使用障碍.
- 这种关联甚至在控制个人接触暴力和其他精神障碍时也被观察到.
- 这些发现强调了集体创伤对弱势群体的重大公共卫生后果.
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