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Abstract
Background
There is increasing evidence that domestic violence (DV) is an important risk factor for suicidal behaviour. The level of risk and its contribution to the overall burden of suicidal behaviour among men and women has not been quantified in South Asia. We carried out a large case-control study to examine the association between DV and self-poisoning in Sri Lanka.
Methods
Cases (N=291) were patients aged ≥18 years, admitted to a tertiary hospital in Kandy Sri Lanka for self-poisoning. Sex and age frequency matched controls were recruited from the hospital’s outpatient department (N=490) and local population (N=450). Exposure to DV was collected through the Humiliation, Afraid, Rape, Kick (HARK) questionnaire. Multivariable logistic regression models were conducted to estimate the association between DV and self-poisoning, and population attributable fractions (PAF) were estimated.
Results
Exposure to at least one type of DV within the previous 12 months was strongly associated with self-poisoning for women (adjusted OR [AOR] 4·08, 95%CI 1·60-4·78) and men (AOR 2·52, 95%CI 1·51-4·21), compared to those reporting no abuse. Among women, the association was strongest for physical violence (AOR 14·07, 95%CI 5·87-33·72), whereas among men, emotional abuse showed the highest risk (AOR 2·75, 95%CI 1·57-4·82). PAF% for exposure to at least one type of DV was 38% (95%CI 32-43) in women and 22% (95%CI 14-29) in men.
Conclusions
Multi-sectoral interventions to address DV including enhanced identification in health care settings, community-based strategies, and integration of DV support and psychological services may substantially reduce suicidal behaviour in Sri Lanka.
There is increasing evidence that domestic violence (DV) is an important risk factor for suicidal behaviour. The level of risk and its contribution to the overall burden of suicidal behaviour among men and women has not been quantified in South Asia. We carried out a large case-control study to examine the association between DV and self-poisoning in Sri Lanka.
Methods
Cases (N=291) were patients aged ≥18 years, admitted to a tertiary hospital in Kandy Sri Lanka for self-poisoning. Sex and age frequency matched controls were recruited from the hospital’s outpatient department (N=490) and local population (N=450). Exposure to DV was collected through the Humiliation, Afraid, Rape, Kick (HARK) questionnaire. Multivariable logistic regression models were conducted to estimate the association between DV and self-poisoning, and population attributable fractions (PAF) were estimated.
Results
Exposure to at least one type of DV within the previous 12 months was strongly associated with self-poisoning for women (adjusted OR [AOR] 4·08, 95%CI 1·60-4·78) and men (AOR 2·52, 95%CI 1·51-4·21), compared to those reporting no abuse. Among women, the association was strongest for physical violence (AOR 14·07, 95%CI 5·87-33·72), whereas among men, emotional abuse showed the highest risk (AOR 2·75, 95%CI 1·57-4·82). PAF% for exposure to at least one type of DV was 38% (95%CI 32-43) in women and 22% (95%CI 14-29) in men.
Conclusions
Multi-sectoral interventions to address DV including enhanced identification in health care settings, community-based strategies, and integration of DV support and psychological services may substantially reduce suicidal behaviour in Sri Lanka.
| Original language | English |
|---|---|
| Pages (from-to) | 1183 - 1191 |
| Journal | Psychological Medicine |
| Volume | 52 |
| Issue number | 6 |
| Early online date | 11 Sept 2020 |
| DOIs | |
| Publication status | Published - 2 Apr 2022 |
Research Groups and Themes
- SASH
Access to Document
- Full-text PDF (author accepted manuscript)
This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Cambridge University Press at https://doi.org/10.1017/S0033291720002986. Please refer to any applicable terms of use of the publisher.
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Dive into the research topics of 'Domestic violence and self-poisoning in Sri Lanka'. Together they form a unique fingerprint.Projects
- 1 Finished
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Hospital based case-control study of self-poisoning in Sri Lanka
Knipe, D. (Principal Investigator), Kidger, J. L. (Co-Investigator), Lopez-Lopez, J. A. (Co-Investigator), Senarathna, L. (Co-Investigator) & Rajapakse, T. N. (Co-Investigator)
8/03/18 → 28/02/19
Project: Research
Profiles
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Dr Duleeka Knipe
- Bristol Medical School (PHS) - Associate Professor in Global Mental Health
- Bristol Poverty Institute
- Migration Mobilities Bristol
- Bristol Population Health Science Institute
Person: Academic , Member