Violence, mental health, and substance abuse in patients who are seen in primary care settings
G. Wyshak and G. A. Modest
Department of Psychiatry, Harvard Medical School, Boston, Mass., USA.
OBJECTIVE: To explore the associations among having feelings of anger,
being the perpetrator or victim of violent acts, having symptoms of
psychiatric distress, and being substance abusers in patients who were seen
in primary care settings. DESIGN AND SETTING: A brief self-administered
questionnaire was completed by adults who were attending ambulatory clinics
of a community hospital and of a neighborhood health center. PARTICIPANTS:
Seventy-three percent of the participants were women; 45% were Hispanic or
Portuguese, 10% were African American, 35% were white, and 10% were of
other ethnic or racial backgrounds; and most were of a lower socioeconomic
status. RESULTS: Feelings of anger and acts of violence were most highly
associated as follows: (1) among men, with being hit as a child, use of
drugs, and symptoms of nervousness; (2) among all women, with a drinking
problem and "being down"; and among white women, with a drinking problem,
being down, and being hit as a child or as an adult or both. Consequences
of being hit as a child were feelings of anger and drug use among men,
drinking problems among all women, and psychiatric symptoms among white
women. CONCLUSIONS: An 18-item self-administered questionnaire can provide
useful information on symptoms of psychiatric distress and substance abuse.
These symptoms may be associated with feelings of anger and violence-both
for the perpetrator and victim. This questionnaire may aid practitioners in
the detection and management of physical and psychologic problems.
