Background

Intimate partner violence (IPV) is a recognised risk factor for psychiatric disorders. There is little current evidence on IPV and self-harm and suicidality, and we therefore aimed to investigate the associations between experience of lifetime and past-year IPV with suicidal thoughts, suicide attempt, and self-harm in the past year.

Methods

We analysed the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional survey of 7058 adults (aged ≥16 years) in England, which used a multistage random probability sampling design and involved face-to-face interviews. Participants were asked about experience of physical violence and sexual, economic, and emotional abuse from a current or former partner, and about suicidal thoughts, suicide attempts, and self-harm. Other adversities were recorded through an adapted version of the List of Threatening Experiences. Multivariable logistic regression models quantified associations between different indicators of lifetime and past-year IPV, with past-year non-suicidal self-harm, suicidal thoughts, and suicide attempts. All analyses were weighted.

Findings

Using weighted percentages, we found that a fifth (21·4%) of 7058 adults reported lifetime experience of IPV, and that 27·2% of women and 15·3% of men had experienced IPV. Among women, 19·6% had ever experienced emotional IPV, 18·7% physical IPV, 8·5% economic IPV, and 3·7% sexual IPV, which was higher than in men (8·6%, 9·3%, 3·6%, and 0·3%, respectively). Findings for ethnicity were unclear. Lifetime prevalence of IPV was higher in those living in rented accommodation or deprived neighbourhoods. Among people who had attempted suicide in the past year, 49·7% had ever experienced IPV and 23·1% had experienced IPV in the past year (including 34·8% of women and 9·4% of men). After adjusting for demographics, socioeconomics, and lifetime experience of adversities, the odds ratio of a past-year suicide attempt were 2·82 (95% CI 1·54–5·17) times higher in those who have ever experienced IPV, compared with those who had not. Fully adjusted odds ratios for past-year self-harm (2·20, 95% CI 1·37–3·53) and suicidal thoughts (1·85, 1·39–2·46) were also raised in those who had ever experienced IPV.

Interpretation

IPV is common in England, especially among women, and is strongly associated with self-harm and suicidality. People presenting to services in suicidal distress or after self-harm should be asked about IPV. Interventions designed to reduce the prevalence and duration of IPV might protect and improve the lives of people at risk of self-harm and suicide.

Funding

UK Prevention Research Partnership.

中文翻译：

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亲密伴侣暴力、自杀和自残：对英格兰普通人群的概率抽样调查

背景

亲密伴侣暴力（IPV）是公认的精神疾病危险因素。目前关于 IPV 与自残和自杀的证据很少，因此我们旨在调查一生和过去一年的 IPV 经历与过去一年的自杀想法、自杀企图和自残之间的关联。

方法

我们分析了 2014 年成人精神病发病率调查，这是一项针对英格兰 7058 名成年人（年龄≥16 岁）的横断面调查，采用多阶段随机概率抽样设计并涉及面对面访谈。参与者被问及来自现任或前任伴侣的身体暴力、性虐待、经济虐待和情感虐待的经历，以及自杀念头、自杀企图和自残的情况。其他逆境是通过威胁经历清单的改编版本记录的。多变量逻辑回归模型量化了不同的寿命指标和过去一年的 IPV 与过去一年的非自杀性自残、自杀想法和自杀企图之间的关联。所有分析均经过加权。

发现

使用加权百分比，我们发现 7058 名成年人中的五分之一 (21·4%) 报告了终生感染过 IPV 的经历，并且 27·2% 的女性和 15·3% 的男性经历过 IPV。女性中，19·6%经历过情感IPV，18·7%经历过身体IPV，8·5%经历过经济IPV，3·7%经历过性IPV，高于男性（8·6%、9·3）。分别为 %、3·6% 和 0·3%）。种族调查结果尚不清楚。居住在出租房或贫困社区的人终生 IPV 患病率较高。在过去一年尝试过自杀的人中，49·7% 的人曾经经历过 IPV，23·1% 的人在过去一年经历过 IPV（其中女性为 34·8%，男性为 9·4%）。在对人口统计、社会经济学和一生逆境经历进行调整后，与经历过 IPV 的人相比，过去一年自杀未遂的几率比经历过 IPV 的人高出 2·82 (95% CI 1·54–5·17) 倍。与那些没有的人一起。过去一年的自残（2·20，95% CI 1·37–3·53）和自杀念头（1·85，1·39–2·46）的完全调整优势比在那些有过自杀行为的人中也有所提高。曾经体验过IPV。

解释

IPV 在英国很常见，尤其是在女性中，并且与自残和自杀密切相关。应向有自杀困扰或自残后就诊的人询问有关 IPV 的情况。旨在减少 IPV 流行率和持续时间的干预措施可能会保护和改善有自残和自杀风险的人们的生活。

资金

英国预防研究伙伴关系。