Objective: We aimed to investigate the mediating effect of violence by a family member or acquaintance on biological sex, depression and suicidal ideation. Methods: We used data from the 2013 Brazilian National Health Survey, a cross-sectional nationwide survey. Major depressive episode and suicidal ideation were evaluated with the Patient Health Questionnaire. Violence victimization and other sociodemographic variables were self-reported. We used logistic regression to estimate the OR, 95%CI and G-computation to calculate the natural direct and indirect effects. Results: A total of 60,202 individuals were evaluated. Women had higher prevalences of major depressive episode (OR = 2.36; 95%CI 2.03-2.74), suicidal ideation (OR = 2.02; 95%CI 1.73-2.36) and violence victimization (OR = 1.73; 95%CI 1.45-2.06). The mediation analysis showed that 10.6% of the association between sex and major depressive episode and 8.0% of the association between sex and suicidal ideation is explained by violence. Conclusions: Women in Brazil have an increased risk of major depressive episode and suicidal ideation, and this association is mediated, in part, by the fact that they suffer more violence from family members or acquaintances.

中文翻译：

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为什么巴西妇女更易患抑郁症和自杀意念：暴力作用的中介分析

目的：我们旨在调查家庭成员或熟人的暴力行为对生理性别、抑郁和自杀意念的中介作用。方法：我们使用了 2013 年巴西全国健康调查的数据，这是一项全国性横断面调查。使用患者健康问卷评估重度抑郁发作和自杀意念。暴力受害和其他社会人口变量是自我报告的。我们使用逻辑回归来估计 OR、95% CI 和 G 计算来计算自然的直接和间接影响。结果：总共评估了 60,202 个人。女性重度抑郁发作 (OR = 2.36; 95%CI 2.03-2.74)、自杀意念 (OR = 2.02; 95%CI 1.73-2.36) 和暴力受害 (OR = 1.73; 95%CI 1.45-2.06) 的发生率较高. 中介分析表明，10. 6% 的性与重性抑郁发作之间的关联以及 8.0% 的性与自杀意念之间的关联是通过暴力来解释的。结论：巴西女性患重度抑郁症和自杀意念的风险增加，这种关联在一定程度上是由于她们遭受更多家庭成员或熟人的暴力。