Lifelong robbery victimisation and mental disorders at age 18 years: Brazilian population-based study

Abstract

PurposeUrban violence is a major problem in Brazil and may contribute to mental disorders among victims. The aim of this study was to assess the association between robbery victimisation and mental health disorders in late adolescence.MethodsAt age 18 years, 4106 participants in the 1993 Pelotas Birth Cohort Study were assessed. A questionnaire about history of robbery victimisation was administered, the Self-Report Questionnaire was used to screen for common mental disorders, and the Mini International Neuropsychiatric Interview was used to assess major depressive disorder and generalised anxiety disorder. Cross-sectional prevalence ratios between lifetime robbery victimisation and mental disorders were estimated using Poisson regression with robust standard errors, adjusting for socioeconomic variables measured at birth and violence in the home and maltreatment measured at age 15.ResultsThere was a dose–response relationship between frequency of lifetime robberies and risk of mental disorders. Adolescents who had been robbed three or more times had twice the risk (PR 2.04; 95% CI 1.64–2.56) for common mental disorders, over four times the risk for depression (PR 4.59; 95% CI 2.60–8.12), and twice the risk for anxiety (PR 1.93; 95% CI 1.06–3.50), compared with non-victims, adjusting for covariates. Experiencing frequent robberies had greater impact on common mental disorders than experiencing an armed robbery. Population attributable fractions with regard to robbery were 9% for common mental disorders, 13% for depression, and 8% for anxiety.ConclusionsRobberies are associated with common mental disorders in late adolescence, independently of violence between family members. Reducing urban violence could significantly help in preventing common mental illnesses.Electronic supplementary materialThe online version of this article (10.1007/s00127-018-1488-z) contains supplementary material, which is available to authorized users.

Robbery Victimization in Early Adulthood, and Depression and Anxiety at Age 30 Years: Results From the 1982 Pelotas (Brazil) Birth Cohort Study

“…Crude (unadjusted) analyses did not reveal associations between mental disorders and robbery occurring over the past 10 years. However, after adjusting for confounders, significant associations were observed, consistent with the results of Murray et al for 18 years old ( 19 ). The association with robbery victimization was higher for comorbidity of MDD and GAD, than that for MDD or GAD alone.…”

“…Robbery is one of the most important forms of exposure to community violence ( 16 – 20 ), and a previous study carried out in Pelotas found that robbery victimization was associated with depression and anxiety among adolescents ( 19 ), in line with other studies performed in high-income countries, such as United States and England ( 21 , 22 ). There is, hence, a substantial set of findings from studies highlighting that community violence, mainly robbery victimization, may be related to mental disorders at different stages in the lifecourse, since robbery victims often report not only feelings of fear and concerns immediately afterwards the victimization, but also apprehension with possible revictimization and mental disorders occurrence, such as major depression and generalized anxiety, even months or years later, for example ( 13 , 23 – 25 ).…”

“…The association with robbery victimization was higher for comorbidity of MDD and GAD, than that for MDD or GAD alone. For decades, research has identified the effects of violence in the home on mental disorders ( 13 , 44 ), but less attention has been given to the specific effects of events such as robbery in the community ( 19 ). This is an important issue, especially in contexts where community violence is common.…”

“…Several mechanisms have been proposed to explain the relationship between community violence and mental disorders throughout the lifecourse ( 46 , 47 ). The short and long-term effects of robbery on mental disorders have been mostly discussed based on different pathophysiological responses focused on trauma ( 19 ) or stressful events with the potential to modify the functioning of the sympathetic nervous system and the axis hypothalamic-pituitary-adrenal (HPA) ( 24 , 48 ), inflammatory mechanisms in the brain and peripherally ( 49 ) or even with epigenetic mechanisms ( 50 ). Regarding depression and anxiety disorders, HPA axis hyperactivity has been the main pathophysiological mechanism associated with stressful events resulting from interpersonal violence, at different stages in the lifecourse ( 51 – 53 ).…”

Exposição à violência e autoavaliação de saúde: análise de dados da Pesquisa Nacional de Saúde (PNS), 2013

“…A natureza transversal do estudo também não nos permite fazer inferências longitudinais sobre a direção da associação estudada. Contudo, existem dados longitudinais que sustentam, pelo contrário, a hipótese de haver, sim, associação, no sentido de a violência causar a depressão e, consequentemente, uma pior autoavaliação de saúde (Murray et al, 2018).…”