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2018 ; 5
(ä): e9
Nephropedia Template TP
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Interpersonal violence and suicidality among former child soldiers and
war-exposed civilian children in Nepal
#MMPMID29507745
Bhardwaj A
; Bourey C
; Rai S
; Adhikari RP
; Worthman CM
; Kohrt BA
Glob Ment Health (Camb)
2018[]; 5
(ä): e9
PMID29507745
show ga
BACKGROUND: Suicide risk reduction is crucial for 15-29-year-old youth, who
account for 46% of suicide deaths in low- and middle-income countries. Suicide
predictors in high-resource settings, specifically depression, do not adequately
predict suicidality in these settings. We explored if interpersonal violence
(IPV) was associated with suicidality, independent of depression, in Nepal.
METHODS: A longitudinal cohort of child soldiers and matched civilian children,
enrolled in 2007 after the People's War in Nepal, were re-interviewed in 2012.
The Depression Self-Rating Scale and Composite International Diagnostic Interview
assessed depression and suicidality, respectively. Non-verbal response cards were
used to capture experiences of sexual and physical IPV. RESULTS: One of five
participants (19%) reported any lifetime suicidal ideation, which was associated
with sexual IPV, female gender, former child soldier status and lack of support
from teachers. Among young men, the relationship between sexual IPV and
suicidality was explained by depression, and teacher support reduced suicidality.
Among young women, sexual IPV was associated with suicidality, independent of
depression; child soldier status increased suicidality, and teacher support
decreased suicidality. Suicide plans were associated with sexual IPV but not with
depression. One of 11 female former child soldiers (9%) had attempted suicide.
CONCLUSION: Sexual IPV is associated with suicidal ideation and plans among
conflict-affected young women, independent of depression. Reducing suicide risk
among women should include screening, care, and prevention programs for sexual
IPV. Programs involving teachers may be particularly impactful for reducing
suicidality among IPV survivors.