近日,，英國利物浦約翰摩爾斯大學的研究者進行的一項大型系統(tǒng)回顧與薈萃分析顯示：每4例成年精神病患者中就有1例在過去一年中成為暴力行為的受害者。相關論文發(fā)表在國際知名期刊The Lancet上,。
“無特定障礙的個體中，約3%在過去12個月內遭遇過暴力,，而精神病患者中該比例上升到近四分之,。一生遭遇暴力、直接遭暴力威脅或生活于害怕成為受害者的傷殘人士比例,，可能大大超過我們的估計,，”作者寫道。
雖然越來越多的研究表明,，殘疾人遭遇暴力的風險增高,，但本研究首次證實這種風險的大小及其與不同類型殘疾之間的關聯(lián)。
全球性問題
研究人員表示,，全球約15％的成年人患有某種類型的殘疾,。他們指出：雖然越來越多的研究“已量化施加于殘疾個體的暴力,，但研究方法與殘疾和暴力的定義千差萬別，并沒有這方面的證據(jù)定量合成,。”
研究人員分析了來自澳大利亞,、加拿大、新西蘭,、臺灣,、英國、美國和臺灣的26項研究（納入21557例個體）的數(shù)據(jù),，進行了回顧,。
研究發(fā)現(xiàn)：精神疾病（24.3％）和智力障礙（6.1％）成人患者中近期自然性伴侶或親密伴侶暴力的發(fā)生率高,。
研究者估計,，殘疾成年人成為暴力受害者的概率為沒有殘疾者的1.5倍，而精神病患者的暴力風險增加了近4倍,。
據(jù)估計,，全球約有15％的成年人患有殘疾，由于人口老齡化與慢性疾病的全球增長,，預計該比率還將上升,。
被遺忘的受害者
作者承認，該研究有幾處潛在局限性,，包括所檢查的各類殘疾與暴力之間的差異,。這主要是由于納入分析的所有研究均源自高收入國家。
“缺乏全球多數(shù)地區(qū)的基本發(fā)生率率與風險的數(shù)據(jù),，特別是低收入與中等收入國家（全球80％的殘疾人生活的地方）,。”
“對受累群體的遭遇暴力行為嚴重性的認識是預防暴力的公共衛(wèi)生方法的第一步，”作者寫道,。
在隨后的社論中,，Esme Fuller-Thomson博士與Sara Brennenstuhl(在讀博士)（均來自加拿大多倫多大學）兩人指出該回顧“強調對殘疾成年人施加的暴力行為嚴重性，提示同心協(xié)力發(fā)現(xiàn)“被遺忘的暴力行為受害者”并采取措施很重要,。”
作者與編輯均宣稱沒有相關財務關系,。（生物谷Bioon.com）
doi:10.1016/S0140-6736(11)61851-5
PMC:
PMID:
Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies
Karen Hughes PhD, Prof Mark A Bellis DSc, Lisa Jones BSc, Sara Wood MSc, Geoff Bates MSc, Lindsay Eckley PhD, Ellie McCoy MSc, Christopher Mikton PhD, Tom Shakespeare PhD, Alana Officer MPH
Background About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.
Methods In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly ≥18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis.
Findings Of 10 663 references initially identified, 26 were eligible for inclusion, with data for 21 557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24·3% (95% CI 18·3—31·0) in people with mental illnesses, 6·1% (2·5—11·1) in those with intellectual impairments, and 3·2% (2·5—4·1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I2 >75%). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1·50 (95% CI 1·09—2·05) for all studies combined, 1·31 (0·93—1·84) for people with non-specific impairments, 1·60 (1·05—2·45) for people with intellectual impairments, and 3·86 (0·91—16·43) for those with mental illnesses.
Interpretation Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries.
Fundin WHO Department of Violence and Injury Prevention and Disability.
