2月28日在线发表于《柳叶刀》（Lancet.2012Feb27.）杂志上的新研究显示：虽然残障人士遭遇暴力的风险显著增高，但精神病患者的风险尤为显著。
英国利物浦约翰摩尔斯大学的研究者进行的一项大型系统回顾与荟萃分析显示：每4例成年精神病患者中就有1例在过去一年中成为暴力行为的受害者。
“无特定障碍的个体中，约3%在过去12个月内遭遇过暴力，而精神病患者中该比例上升到近四分之。一生遭遇暴力、直接遭暴力威胁或生活于害怕成为受害者的伤残人士比例，可能大大超过我们的估计，”作者写道。
虽然越来越多的研究表明，残疾人遭遇暴力的风险增高，但本研究首次证实这种风险的大小及其与不同类型残疾之间的关联。
全球性问题
研究人员表示，全球约15％的成年人患有某种类型的残疾。他们指出：虽然越来越多的研究“已量化施加于残疾个体的暴力，但研究方法与残疾和暴力的定义千差万别，并没有这方面的证据定量合成。”
研究人员分析了来自澳大利亚、加拿大、新西兰、台湾、英国、美国和台湾的26项研究（纳入21557例个体）的数据，进行了回顾。
研究发现：精神疾病（24.3％）和智力障碍（6.1％）成人患者中近期自然性伴侣或亲密伴侣暴力的发生率高。
研究者估计，残疾成年人成为暴力受害者的概率为没有残疾者的1.5倍，而精神病患者的暴力风险增加了近4倍。
据估计，全球约有15％的成年人患有残疾，由于人口老龄化与慢性疾病的全球增长，预计该比率还将上升。
被遗忘的受害者
作者承认，该研究有几处潜在局限性，包括所检查的各类残疾与暴力之间的差异。这主要是由于纳入分析的所有研究均源自高收入国家。
“缺乏全球多数地区的基本发生率率与风险的数据，特别是低收入与中等收入国家（全球80％的残疾人生活的地方）。”
“对受累群体的遭遇暴力行为严重性的认识是预防暴力的公共卫生方法的第一步，”作者写道。
在随后的社论中，Esme Fuller-Thomson博士与Sara Brennenstuhl(在读博士)（均来自加拿大多伦多大学）两人指出该回顾“强调对残疾成年人施加的暴力行为严重性，提示同心协力发现“被遗忘的暴力行为受害者”并采取措施很重要。”
作者与编辑均宣称没有相关财务关系。
Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies
Karen Hughes PhD, Prof Mark A Bellis DSc, Lisa Jones BSc, Sara Wood MSc, Geoff Bates MSc, Lindsay Eckley PhD, Ellie McCoy MSc, Christopher Mikton PhD, Tom Shakespeare PhD, Alana Officer MPH
Background About 15% of adults worldwide have a disability. These individuals are frequently reported to be at increased risk of violence, yet quantitative syntheses of studies of this issue are scarce. We aimed to quantify violence against adults with disabilities.
Methods In this systematic review and meta-analysis, we searched 12 electronic databases to identify primary research studies published between Jan 1, 1990, and Aug 17, 2010, reporting prevalence estimates of violence against adults (aged mainly ≥18 years) with disabilities, or their risk of violence compared with non-disabled adults. We included only studies reporting violence occurring within the 12 months before the study. We assessed studies with six core quality criteria, and pooled data for analysis.
Findings Of 10 663 references initially identified, 26 were eligible for inclusion, with data for 21 557 individuals with disabilities. 21 studies provided data suitable for meta-analysis of prevalence of violence, and ten for meta-analysis of risks of violence. Pooled prevalence of any (physical, sexual, or intimate partner) recent violence was 24·3% (95% CI 18·3—31·0) in people with mental illnesses, 6·1% (2·5—11·1) in those with intellectual impairments, and 3·2% (2·5—4·1) in those with non-specific impairments. We identified substantial heterogeneity in most prevalence estimates (I2 >75%). We noted large uncertainty around pooled risk estimates. Pooled crude odds ratios for the risk of violence in disabled compared with non-disabled individuals were 1·50 (95% CI 1·09—2·05) for all studies combined, 1·31 (0·93—1·84) for people with non-specific impairments, 1·60 (1·05—2·45) for people with intellectual impairments, and 3·86 (0·91—16·43) for those with mental illnesses.
Interpretation Adults with disabilities are at a higher risk of violence than are non-disabled adults, and those with mental illnesses could be particularly vulnerable. However, available studies have methodological weaknesses and gaps exist in the types of disability and violence they address. Robust studies are absent for most regions of the world, particularly low-income and middle-income countries.
Fundin WHO Department of Violence and Injury Prevention and Disability.
文献链接：https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61851-5/fulltext
