@article{ref1,
title="The impact of trauma, substance abuse, and psychiatric illness on suicidal and  self-harm behaviours in a cohort of migrant detainees: an observational, prospective  study",
journal="International journal of social psychiatry",
year="2020",
author="Marchi, Mattia and Artoni, Cecilia and Longo, Fedora and Magarini, Federica Maria and Aprile, Giovanni and Reggianini, Corinna and Florio, Debora and De Fazio, Giovanna Laura and Galeazzi, Gian Maria and Ferrari, Silvia",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: According to the WHO, detainees attempt suicide ten times more than the  general population. AIMS: To investigate the impact of migration trauma on Suicidal  and Self-Harm Behaviours (SSHB) of migrants in jail and to explore how substance use  and other psychiatric features affect this relationship. <br><br>METHODS: Prospective cohort  study, conducted at the 'Sant'Anna' jail in Modena (Italy) between February 2017 and  September 2019. Socio-demographic, psychiatric features and records of previous SSHB  were collected. Experience of migration-related trauma was assessed with the LiMEs  (List of Migration Experiences) checklist. Participants were followed-up for the  occurrence of further SSHB. Survival analysis was performed and Cox's Hazard Ratios  (HR) were used as a measure of association of comparisons. <br><br>RESULTS: Amongst the 112  subjects (96% male, median age 33), the prevalence of any mental disorder was 26%  and of substance abuse 59%. History of SSHB was present in 36% of the sample. Median  follow-up time was 80 days. During follow-up, 11 events were observed (of which  three were suicide attempts). Cumulative survival probability was 85%. Having  experienced trauma related to war and violence was significantly associated with  SSHB, HR: 7.05. No SSHB were recorded amongst subjects without substance abuse. <br><br>CONCLUSIONS: Migrants in custody who experienced trauma in the post-migration  period, attempt SSHB seven times more frequently than those without traumas at any  time. War trauma and post-migration trauma due to exposure to violence seem to be  more strongly associated with SSHB, also controlling for psychiatric diagnosis,  ongoing psychopharmacological therapy and substance abuse. Further research and  possible intervention programs should focus on addressing post-migration  living-difficulties.<p /> <p>Language: en</p>",
language="en",
issn="0020-7640",
doi="10.1177/0020764020979007",
url="http://dx.doi.org/10.1177/0020764020979007"
}