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Domestic violence and self-poisoning in Sri Lanka

Published online by Cambridge University Press:  11 September 2020

Piumee Bandara Open the ORCID record for Piumee Bandara [Opens in a new window] ,
Andrew Page ,
Lalith Senarathna ,
Judi Kidger ,
Gene Feder ,
David Gunnell ,
Thilini Rajapakse  and
Duleeka Knipe
Piumee Bandara*
Affiliation:
Translational Health Research Institute, Western Sydney University, New South Wales, Australia South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
Andrew Page
Affiliation:
Translational Health Research Institute, Western Sydney University, New South Wales, Australia
Lalith Senarathna
Affiliation:
South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka Department of Health Promotion, Faculty of Applied Sciences, Rajarata University of Sri Lanka, Mihintale, Sri Lanka
Judi Kidger
Affiliation:
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
Gene Feder
Affiliation:
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
David Gunnell
Affiliation:
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
Thilini Rajapakse
Affiliation:
South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
Duleeka Knipe
Affiliation:
South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
*
Author for correspondence: Piumee Bandara, E-mail: p.bandara@westernsydney.edu.au
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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 questionnaire. Multivariable logistic regression models were conducted to estimate the association between DV and self-poisoning, and population attributable fractions were calculated.

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.

Keywords

Domestic violencegender-based violenceintimate partner violenceself-harmself-poisoningsuicidal behavioursuicidesuicide attemptSri LankaSouth Asia
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 6 , April 2022 , pp. 1183 - 1191
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

These authors contributed equally.

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