Childhood adversity and self-poisoning: A hospital case control study in Sri Lanka

Adverse childhood experiences (ACE) have been recognized as an important risk factor for suicidal behaviour among adults, but evidence from low and middle-income countries is lacking. This study explored associations between ACE and hospital admission due to non-fatal self-poisoning in Sri Lanka. Th...

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Vydáno v:	PloS one Ročník 15; číslo 11; s. e0242437
Hlavní autoři:	Rajapakse, Thilini, Russell, Abigail Emma, Kidger, Judi, Bandara, Piumee, López-López, José A., Senarathna, Lalith, Metcalfe, Chris, Gunnell, David, Knipe, Duleeka
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 19.11.2020 Public Library of Science (PLoS)
Témata:	Abuse Adolescent Adult Adults Adverse childhood experiences Adverse Childhood Experiences - prevention & control Adverse Childhood Experiences - statistics & numerical data Adversity Aged Aggression Bereavement Biology and Life Sciences Case-Control Studies Child Abuse Child abuse & neglect Childhood Childhood experiences Childhood factors Children Confounding Factors, Epidemiologic Developing Countries Disease management Divorce Domestic Violence Emotional abuse Ethnicity Ethnicity - statistics & numerical data Female Health risks Health sciences Hospitalization Households Humans Interview, Psychological Low income groups Male Marital disruption Medical research Medical schools Medicine Medicine and Health Sciences Mental disorders Mental health Mental health services Middle Aged Minority & ethnic groups Parental death Patients Poisoning Poisoning - epidemiology Population Psychological aspects Public health Questionnaires Regression analysis Regression models Religion Risk Risk analysis Risk factors Risk taking Self destructive behavior Self injury Self poisoning Self-Injurious Behavior Selfpoisoning Sex Social aspects Social Sciences Socioeconomic Factors Sri Lanka - epidemiology Suicidal behavior Suicide Suicide, Attempted - psychology Suicide, Attempted - statistics & numerical data Suicides & suicide attempts Teaching hospitals Tertiary Care Centers - statistics & numerical data Young Adult Sri Lanka United Kingdom > UK South Asia
ISSN:	1932-6203, 1932-6203
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Shrnutí:	Adverse childhood experiences (ACE) have been recognized as an important risk factor for suicidal behaviour among adults, but evidence from low and middle-income countries is lacking. This study explored associations between ACE and hospital admission due to non-fatal self-poisoning in Sri Lanka. This was a case-control study. Adults admitted to a tertiary care hospital for medical management of self-poisoning were included as cases, and age and sex matched controls were recruited from the outpatient department. ACE were measured using the World Health Organization's Childhood Adversity Scale. Logistic regression models adjusting for age, sex, ethnicity, and religion were used to quantify the association between ACE and self-poisoning. The study included 235 cases and 451 controls. Cases were 2.5 times (95% CI 1.8, 3.6) more likely to report an ACE than controls and had higher ACE scores. Childhood physical abuse (OR 4.7, 95% CI 1.2, 19.0) and emotional abuse or neglect (OR 3.7, 95% CI 1.3, 10.1, and 3.7, 95% CI 2.3, 6.0 respectively), increased the risk of self-poisoning in adulthood, as did witnessing household violence (OR 2.2, 95% CI 1.4, 3.4), growing up in a household with a mentally ill or suicidal household member (OR 2.1, 95% CI 1.2, 3.4), and experiencing parental death/separation/divorce (OR 3.1, 95% CI 2.0, 4.9) as a child. Reducing exposures to ACEs should be a priority for prevention of suicide and self-harm in Sri Lanka. Innovative methods to increase support for children facing adversity should be explored.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have declared that no competing interest exists.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0242437