Violence exposure among adolescent psychiatric patients in Nepal: Socio-demographic and familial risk factors.

BACKGROUND

Violence exposure is a major public health concern among adolescents. Yet, evidence on socio-demographic and familial risk factors in adolescent psychiatric populations in Nepal and other low- and middle-income countries is limited.

OBJECTIVES

To identify risk factors associated with different forms of violence exposure among adolescents attending a child and adolescent psychiatric unit in Nepal.

METHODS

A total of 810 adolescents aged 11-15 years (392 boys, 418 girls) at Kanti Children's Hospital in Kathmandu, were included. Adolescents reported past-year exposure to violence using adapted PedHITSS and ICAST-C items, while parents provided socio-demographic and family data. Associations were examined using ordinal and logistic regression analyses in SPSS 29.

RESULTS

Physical abuse was more frequent among adolescents from the Dalit caste (OR 1.86, 95% CI 1.03-3.34, p = 0.04), whereas neglect and domestic violence were more frequent among Indigenous/minority groups compared with Brahmin/Chhetri castes (OR 1.72, 95% CI 1.17-2.52, p = 0.006; OR 1.63, 95% CI 1.17-2.27, p = 0.004). Compared with urban areas, emotional abuse was less frequent in rural (OR 0.52, 95% CI 0.34-0.80, p = 0.003) and semi-urban areas (OR 0.60, 95% CI 0.41-0.85, p = 0.005), while sexual abuse and neglect were less frequent in semi-urban areas (OR 0.40, 95% CI 0.21-0.77, p = 0.01; OR 0.35, 95% CI 0.20-0.60, p < 0.001). Emotional abuse, sexual abuse, and neglect were more frequent among females (OR 1.59, 95% CI 1.19-2.13, p = 0.002; OR 3.70, 95% CI 2.27-6.06, p < 0.001; OR 1.75, 95% CI 1.22-2.50, p = 0.002). Increasing maternal age was associated with lower odds of emotional abuse (OR 0.97, 95% CI 0.95-1.00, p = 0.02). Emotional abuse and domestic violence were more frequent in single-parent families compared with extended families (OR 1.98, 95% CI 1.04-3.78, p = 0.04; OR 2.84, 95% CI 1.04-7.78, p = 0.001), and parental illiteracy was linked to increased domestic violence compared with university-level education (OR 2.93, 95% CI 1.15-7.49, p = 0.03).

CONCLUSION

Violence exposure was more frequent among Dalit and Indigenous/minority groups, females, urban residents, was associated with younger maternal age, single-parent households, and parental illiteracy reflecting need for culturally informed, trauma-focused prevention and intervention.