Violence-related injury and gender: The role of alcohol and alcohol combined with illicit drugs.

INTRODUCTION AND AIMS: The positive relationship between alcohol use, gender and violence-related injury is well established. However, less is known about injuries when alcohol is used in combination with other drugs. DESIGN AND METHODS: Self-report information was collected on alcohol and illicit drug use in the 6 h before a violence-related injury in probability samples of patients presenting to emergency departments (n = 9686). RESULTS: Patients with violence-related injuries reported the highest rates of alcohol use (49% of men; 23% of women) and alcohol use combined with illicit drugs (8% of men; 4% of women) whereas non-violent injury patients reported lower rates of alcohol use (17% of men; 8% of women) and alcohol use combined with drugs (2% for men; 1% for women). Marijuana/hashish was the most commonly reported drug. The odds of a violent injury were increased when alcohol was used [men: odds ratio (OR) = 5.4, 95% confidence interval (CI) 4.6-6.3; women: OR = 4.0, 95% CI 3.0-5.5] or when alcohol was combined with illicit drug use before the injury (men: OR = 6.6, 95% CI 4.7-9.3; women: OR = 5.7, 95% CI = 2.7-12.2) compared with non-users. No significant change in the odds of a violent injury was observed for men or women when alcohol users were compared with alcohol and drug users. DISCUSSION AND CONCLUSIONS: The positive association between alcohol and violent injury does not appear to be altered by the added use of drugs. Additional work is needed to understand the interpersonal, contextual and cultural factors related to substance use to identify best prevention practices and develop appropriate policies. [Korcha RA, Cherpitel CJ, Witbrodt J, Borges G, Hejazi-Bazargan S, Bond JC, Ye Y, Gmel G. Violence-related injury and gender: The role of alcohol and alcohol combined with illicit drugs. Drug Alcohol Rev 2014;33:43-50].

Violence in primary care: prevalence and follow-up of victims.

BACKGROUND: Primary care physicians underestimate the prevalence of domestic violence and community violence. Victims are therefore at risk of further episodes of violence, with psychological and physical consequences. We used an interview to assess the prevalence of domestic and community violence among Swiss natives and foreigners. In a follow-up study, we evaluated the consequences of the interview for the positive patients. METHODS: We evaluated the prevalence of violence by use of a questionnaire in an interview, in an academic general internal medicine clinic in Switzerland. In a follow-up, we evaluated the consequences of the interview for positive patients. The participants were 38 residents and 446 consecutive patients. Questionnaires were presented in the principal language spoken by our patients. They addressed sociodemographics, present and past violence, the security or lack of security felt by victims of violence, and the patients' own violence. Between 3 and 6 months after the first interview, we did a follow-up of all patients who had reported domestic violence in the last year. RESULTS: Of the 366 patients included in the study, 36 (9.8%) reported being victims of physical violence during the last year (physicians identified only 4 patients out of the 36), and 34/366 (9.3%) reported being victims of psychological violence. Domestic violence was responsible for 67.3% of the cases, and community violence for 21.8%. In 10.9% of the cases, both forms of violence were found. Of 29 patients who reported being victims of domestic violence, 22 were found in the follow-up. The frequency of violence had diminished (4/22) or the violence had ceased (17/22). CONCLUSION: The prevalence of violence is high; domestic violence is more frequent than community violence. There was no statistically significant difference between the Swiss and foreign patients' responses related to the rates of violence. Patients in a currently violent relationship stated that participating in the study helped them and that the violence decreased or ceased a few months later.

Sens et non-sens de la violence : nouvelles expressions, nouvelles approches.

Retrouver le sens de la violence est une démarche certes essentielle, mais non suffisante. Il s'agit aussi d'aller au-delà du sens et de revoir sans cesse les réponses aux expressions nouvelles et inattendues des phénomènes violents, individuels ou collectifs. Cherchant à dépasser une dramatisation de la problématique de la violence des jeunes, ce livre offre des perspectives de réflexion et d'action utiles aux professionnels de la santé mentale des enfants et des adolescents, et plus largement à tous les partenaires du réseau social, éducatif et scolaire. 1. Définition et sources de la violence : Infamies d'enfance. - Agressivité, haine et destructivité: les racines de la violence. - L'enfance des patients adultes diagnostiqués de "paraphilie". - La violence, ses sources pulsionnelles et sa genèse psychique. 2. Formes de violence : Réalités et énigmes de la sexualité infantile déviante. - Les parents battus. - Le harcèlement entre jeunes du même âge. L'arrière-plan familial des jeunes impliqués. - Comportements psychopathiques et réactivité traumatique. - La transgression dans les camps d'extermination nazis. Perdre son âme. Sauver la vie. 3. Psychopathologie. 4. Traitements : De la consommation de substances à la dépendance: un modèle intégratif. - Agressivité et transfert dans le quotidien psychothérapeutique. - Expériences d'interventions au niveau des cellules d'urgences médico-psychologiques. - Sens et non-sens de la violence. - Violences et soins à l'adolescence. - Evacuation et représentation de la violence chez l'enfant psychotique. - La violence pulsionnelle et ses répercussions transférentielles. - Dystraitance. Un accompagnement institutionnel.