Abstract：
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.
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.
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.
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.
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.
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.
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.
摘要：
背景：为了调查精神分裂症患者预后不良的风险，精神病,自杀,自我伤害,台湾2000年至2015年成人暴力后的死亡率。
方法：本研究使用了来自国家健康保险研究数据库（NHIRD）的门诊，紧急情况,以及2000年至2015年参加国家健康保险（NHI）的200万人的住院就诊。案例研究定义了ICD-9诊断代码N代码995.8（受虐待的成年人）或E代码E960-E969（杀人和他人故意伤害）。它分析了18-64岁成年人的首次暴力（研究组）。1：4的比例与受伤和非暴力患者（对照组）相匹配。配对变量是性别，年龄（±1岁），暴露于Charlson合并症指数之前,和一年的医疗。采用SAS9.4和Cox回归进行统计分析。
结果：总计，8,726人经历了暴力（病例组），而34,904人在15年内没有经历过暴力（对照组）。精神分裂症的暴力受害者预后不良的患病率为25.4/104、31.3/104、10.5/10、4和104.6/104，精神病,自杀或自我伤害和死亡，分别。在成年人中，自杀或自我伤害的风险，精神分裂症,精神病,暴露于暴力（平均9年）后的死亡率为6.87-，5.63-,4.10-，和2.50倍（p<0.01），分别,与没有暴力的人相比。在男性中，风险为5.66-，3.85-,3.59-和2.51-倍高，分别,比没有暴力的人(p<0.01)，他们是21.93-，5.57-，女性比没有暴力的女性高4.60倍和2.46倍（p<0.01）。
结论：精神分裂症患者预后不良的风险，精神病,自杀,成人暴力后或自我伤害和死亡率高于未经历暴力伤害的人。成年人因遭受暴力伤害而遭受暴力自杀或自我伤害的风险最高-男性有患精神分裂症的风险，女性有自杀或自我伤害的风险。因此,社会工作者和医务人员有必要关注暴力受害者的心理状况。
方法：本研究使用了来自国家健康保险研究数据库（NHIRD）的门诊，紧急情况,以及2000年至2015年参加国家健康保险（NHI）的200万人的住院就诊。案例研究定义了ICD-9诊断代码N代码995.8（受虐待的成年人）或E代码E960-E969（杀人和他人故意伤害）。它分析了18-64岁成年人的首次暴力（研究组）。1：4的比例与受伤和非暴力患者（对照组）相匹配。配对变量是性别，年龄（±1岁），暴露于Charlson合并症指数之前,和一年的医疗。采用SAS9.4和Cox回归进行统计分析。
结果：总计，8,726人经历了暴力（病例组），而34,904人在15年内没有经历过暴力（对照组）。精神分裂症的暴力受害者预后不良的患病率为25.4/104、31.3/104、10.5/10、4和104.6/104，精神病,自杀或自我伤害和死亡，分别。在成年人中，自杀或自我伤害的风险，精神分裂症,精神病,暴露于暴力（平均9年）后的死亡率为6.87-，5.63-,4.10-，和2.50倍（p<0.01），分别,与没有暴力的人相比。在男性中，风险为5.66-，3.85-,3.59-和2.51-倍高，分别,比没有暴力的人(p<0.01)，他们是21.93-，5.57-，女性比没有暴力的女性高4.60倍和2.46倍（p<0.01）。
结论：精神分裂症患者预后不良的风险，精神病,自杀,成人暴力后或自我伤害和死亡率高于未经历暴力伤害的人。成年人因遭受暴力伤害而遭受暴力自杀或自我伤害的风险最高-男性有患精神分裂症的风险，女性有自杀或自我伤害的风险。因此,社会工作者和医务人员有必要关注暴力受害者的心理状况。
