Injuries/Violence
Interpersonal violent injury and psychiatric disorder: Retrospective analysis of population-based, longitudinal Norwegian register data Sidra Goldman-Mellor* Sidra Goldman-Mellor Ping Qin
Interpersonal violent injury is a major public health problem, with potential adverse impacts on population mental health. However, rigorous epidemiologic research on this topic remains lacking. We aimed to examine how exposure to violent injury is associated with treatment for psychiatric disorder using nationwide longitudinal registry data from Norway. We identified all Norwegians presenting to emergency services in 2010-2018 with violent injury, along with sex- and age-matched control individuals from the general population. The primary outcome was subsequent outpatient or inpatient treatment for psychiatric disorder, observed through December 31, 2018. Psychiatric treatment rates in each study group were compared using stratified multivariable Cox regression models, controlling for sociodemographic characteristics and psychiatric history. Secondary analyses tested for moderation by sex, age, and prior psychiatric treatment, and examined congruence between pre- and post-violence psychiatric diagnoses. We found that violence-injured patients (n=28,276) had substantially higher rates of subsequent psychiatric treatment (102.8 per 100,000 person-years) when compared to controls (26.9 per 100,000), even after accounting for covariates (HRadj: 2.36; 95% CI: 2.29, 2.42). The association between violence injury and psychiatric treatment increased with age. Substance use, mood, and anxiety disorders were the most common diagnoses among violence-injured patients at follow-up. Twenty percent of violence-injured patients, vs. 6% of controls, had a history of prior psychiatric treatment, with high rates of pre- and post-violence diagnostic congruence. Our results suggest that violence-injured patients face substantial burden of psychiatric disorder, especially for substance use and mood/anxiety disorders. Clinical and public health strategies are needed to address this burden, which precedes violent injury in some cases but is likely provoked or exacerbated by it in others.