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Adult abuse and poor prognosis in Taiwan, 2000-2015: a cohort study. BMC Public Health 2022; 22:2280. [PMID: 36474217 PMCID: PMC9724336 DOI: 10.1186/s12889-022-14663-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To 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. METHODS This 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. RESULTS In 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. CONCLUSION The 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.
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Willoughby M, Keen C, Young JT, Spittal MJ, Borschmann R, Janca E, Kinner SA. Violence-related morbidity among people released from prison in Australia: A data linkage study. Drug Alcohol Rev 2021; 41:457-466. [PMID: 34510627 DOI: 10.1111/dar.13380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/22/2021] [Accepted: 08/09/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION People released from prison have an increased risk of morbidity, including from nonfatal violence. We examined the incidence and predictors of violence-related morbidity after release from prison and investigated whether there are differences according to sex and Indigenous status. METHODS Baseline data were collected from 1325 people within 6 weeks of release from prisons in Queensland, Australia, between 1 August 2008 and 31 July 2010. Data were linked to state-wide health (ambulance, emergency department and hospital) and prison records, and national death records until 31 July 2012. Predictors were identified using a multivariable Andersen-Gill model. Differences according to sex and Indigenous status were investigated using effect modification. RESULTS A total of 225 (18.2%) people experienced 410 violence-related events that were recorded in health records. The incidence was 12.8 per 100 person-years [95% confidence interval (CI) 11.7, 14.1]. Risk factors for violence-related morbidity included diagnosed mental illness [hazard ratio (HR) = 2.0, 95% CI 1.1, 3.8], substance use disorder (HR = 1.6, 95% CI 1.1, 2.3) or dual diagnosis (HR = 3.2, 95% CI 2.2, 4.8); high-risk alcohol use (HR = 2.1, 95% CI 1.5, 2.8); being Indigenous (HR = 1.7, 95% CI 1.2, 2.5); and two or more prison releases (HR = 1.7, 95% CI 1.2, 2.6). Indigenous status modified the risk of violence-related morbidity, with Indigenous men having twice the risk of non-Indigenous men (HR = 1.9, 95% CI 1.3, 2.8). DISCUSSION AND CONCLUSIONS Approximately one in five people released from prisons in Queensland experienced violence-related morbidity. Coordinated and continuous mental health and substance use treatment from prison to the community may reduce the risk of violence-related morbidity in this population.
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Affiliation(s)
- Melissa Willoughby
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Claire Keen
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,School of Population and Global Health, The University of Western Australia, Perth, Australia.,National Drug Research Institute, Curtin University, Perth, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Rohan Borschmann
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Emilia Janca
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Stuart A Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Mater Research Institute-UQ, University of Queensland, Mater Hospital, Brisbane, Australia.,Griffith Criminology Institute, Griffith University, Brisbane, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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