MULTIPLE DOMAINS OF VIOLENCE EXPOSURE AND PSYCHOLOGICAL DISTRESS AMONG CIVIL SERVANTS IN RIO DE JANEIRO, BRAZIL: A PROSPECTIVE COHORT STUDY

Lopes, Claudia

MULTIPLE DOMAINS OF VIOLENCE EXPOSURE AND PSYCHOLOGICAL DISTRESS AMONG CIVIL SERVANTS IN RIO DE JANEIRO, BRAZIL: A PROSPECTIVE COHORT STUDY

Monday, 18 August 2014

Exhibit hall (Dena'ina Center)

Claudia S Lopes, PhD , Institute of Social Medicine (IMS), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil

Claudia L Moraes, PhD , Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil

Washington L Junger, PhD , Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil

Guilherme L Werneck, PhD , Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil

Antonio C Ponce de Leon, PhD , Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil

Eduardo L Faerstein, PhD , Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil

INTRODUCTION: Despite escalating urban violence in recent decades, mainly in developing countries, the literature on the impact of this type of exposure on mental health is scarce. This study aims to examine the effects of exposure to violence on the occurrence and persistence of psychological distress, to investigate the effects of contextual violence on the risk of psychological distress, and to evaluate the interaction between contextual and individual violence on the occurrence/persistence of psychological distress.

METHODS: Prospective longitudinal study carried out among 3,058 civil servants working at university campuses in Rio de Janeiro. Psychological distress was measured using the General Health Questionnaire, and exposure to individual violence was assessed as direct (DV), indirect (IV), and both direct and indirect (DIV). Community violence was evaluated through the geocoding of addresses of study participants and the rate of homicides by area of residence. Multiple logistic regression was used to evaluate individual and contextual correlates of psychological distress.

RESULTS: Exposure to DIV increased by six times (95% CI 2.5–14.8) the risk of psychological distress occurrence at the six-year follow-up. Regarding persistence of psychological distress, the association with violence exposure was 1.8 (95% CI 1.2–2.8) for DV and 2.7 (95% CI 1.3–5.6) for IV. Community violence was not associated with psychological distress, and no interaction effect was found between exposure to individual and contextual violence in the occurrence/persistence of psychological distress.

CONCLUSIONS: Results of this study highlight the importance of assessing multiple forms of violence in research on the social determinants of mental disorders. As a key point of this study, we believe that future research must continue to investigate the impact of high rates of chronic community violence on the prevalence of mental disorders among those living in large urban centers.