Intimate partner violence & depression: a deadly comorbidity.
01 Jan 2005-Journal of Psychosocial Nursing and Mental Health Services (J Psychosoc Nurs Ment Health Serv)-Vol. 43, Iss: 1, pp 44-51
TL;DR: Frequent, consistent support of clients experiencing IPV from their families and friends is of considerable importance and can facilitate the buffering effects of such support against suicidal ideation and suicidal attempts.
Abstract: (1) Clients exposed to intimate partner violence (IPV) are at considerable risk for depression, suicide, and homicide. (2) Disclosure of IPV should be accompanied by nonjudgmental, careful, clear documentation of physical and emotional findings by nurses, including direct statements in clients' own words. (3) Frequent, consistent support of clients experiencing IPV from their families and friends (including nonjudgmental listening, unconditional acceptance, discussion of options, and exploring decisions) is of considerable importance and can facilitate the buffering effects of such support against suicidal ideation and suicidal attempts.
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TL;DR: There is insufficient evidence to implement a screening programme for partner violence against women either in health services generally or in specific clinical settings, and psychological interventions may be effective, but not necessarily for women identified through screening.
Abstract: OBJECTIVES: The two objectives were: (1) to identify, appraise and synthesise research that is relevant to selected UK National Screening Committee (NSC) criteria for a screening programme in relation to partner violence; and (2) to judge whether current evidence fulfils selected NSC criteria for the implementation of screening for partner violence in health-care settings. DATA SOURCES: Fourteen electronic databases from their respective start dates to 31 December 2006. REVIEW METHODS: The review examined seven questions linked to key NSC criteria: QI: What is the prevalence of partner violence against women and what are its health consequences? QII: Are screening tools valid and reliable? QIII: Is screening for partner violence acceptable to women? QIV: Are interventions effective once partner violence is disclosed in a health-care setting? QV: Can mortality or morbidity be reduced following screening? QVI: Is a partner violence screening programme acceptable to health professionals and the public? QVII: Is screening for partner violence cost-effective? Data were selected using different inclusion/exclusion criteria for the seven review questions. The quality of the primary studies was assessed using published appraisal tools. We grouped the findings of the surveys, diagnostic accuracy and intervention studies, and qualitatively analysed differences between outcomes in relation to study quality, setting, populations and, where applicable, the nature of the intervention. We systematically considered each of the selected NSC criteria against the review evidence. RESULTS: The lifetime prevalence of partner violence against women in the general UK population ranged from 13% to 31%, and in clinical populations it was 13-35%. The 1-year prevalence ranged from 4.2% to 6% in the general population. This showed that partner violence against women is a major public health problem and potentially appropriate for screening and intervention. The HITS (Hurts, Insults, Threatens and Screams) scale was the best of several short screening tools for use in health-care settings. Most women patients considered screening acceptable (range 35-99%), although they identified potential harms. The evidence for effectiveness of advocacy is growing, and psychological interventions may be effective, but not necessarily for women identified through screening. No trials of screening programmes measured morbidity and mortality. The acceptability of partner violence screening among health-care professionals ranged from 15% to 95%, and the NSC criterion was not met. There were no cost-effectiveness studies, but a Markov model of a pilot intervention to increase identification of survivors of partner violence in general practice found that such an intervention was potentially cost-effective. CONCLUSIONS: Currently there is insufficient evidence to implement a screening programme for partner violence against women either in health services generally or in specific clinical settings. Recommendations for further research include: trials of system-level interventions and of psychological and advocacy interventions; trials to test theoretically explicit interventions to help understand what works for whom, when and in what contexts; qualitative studies exploring what women want from interventions; cohort studies measuring risk factors, resilience factors and the lifetime trajectory of partner violence; and longitudinal studies measuring the long-term prognosis for survivors of partner violence.
346 citations
TL;DR: Depressive and anxiety symptoms are found to occur commonly during pregnancy in Bangladesh, drawing attention to a need to screen for depression and anxiety during antenatal care.
Abstract: Background: Few studies have examined the associated factors of antepartum depressive and anxiety symptoms (ADS and AAS) in low-income countries, yet the World Health Organization identifies depressive disorders as the second leading cause of global disease burden by 2020. There is a paucity of research on mental disorders and their predictors among pregnant women in Bangladesh. This study aims to estimate the prevalence of depressive and anxiety symptoms and explore the associated factors in a cross-section of rural Bangladeshi pregnant women. Methods: The study used cross-sectional data originating from a rural community-based prospective cohort study of 720 randomly selected women in their third trimester of pregnancy from a district of Bangladesh. The validated Bangla version of the Edinburgh Postnatal Depression Scale was used to measure ADS, and a trait anxiety inventory to assess general anxiety symptoms. Background information was collected using a structured questionnaire at the respondents’ homes. Results: Prevalence of ADS was 18% and AAS 29%. Women’s literacy (OR 0.59, 95% CI 0.37-0.95), poor partner relationship (OR 2.23, 95% CI 3.37-3.62), forced sex (OR 1.95, 95% CI 1.01-3.75), physical violence by spouse (OR 1.69, 95% CI 1.02-2.80), and previous depression (OR 4.62 95% CI 2.72-7.85) were found to be associated with ADS. The associated factors of AAS were illiteracy, poor household economy, lack of practical support, physical partner violence, violence during pregnancy, and interaction between poor household economy and poor partner relationship. Conclusion: Depressive and anxiety symptoms are found to occur commonly during pregnancy in Bangladesh, drawing attention to a need to screen for depression and anxiety during antenatal care. Policies aimed at encouraging practical support during pregnancy, reducing gender-based violence, supporting women with poor partner relationships, and identifying previous depression may ameliorate the potentially harmful consequences of antepartum depression and anxiety for the women and their family, particularly children.
220 citations
Cites background from "Intimate partner violence & depress..."
...The direct association between poverty and depression is well documented in high-income countries [30,31], Table 3 Linear regression models examining associated factors of general anxiety symptoms among rural Bangladeshi women during third trimester of pregnancy (N = 720)...
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TL;DR: Depression is common during pregnancy and is associated with indicators of socio-economic deprivation, violence and the loss of an intimate relationship, and with a previous history of depression.
Abstract: Background: Depression in women is associated with social deprivation and violence. We describe the prevalence and risk factors for depression during pregnancy, in particular the association with poverty and violence, in a Brazilian setting. Method: A cross-sectional survey of women in the third trimester of pregnancy attending a public hospital maternity clinic from august 2003 to july 2004 in Rio de Janeiro. Participants were interviewed about their sociodemographic status, obstetric and medical conditions, substance use, stressful life events, and social support. Depression was diagnosed through the composite international diagnostic interview (cidi). Results. A total of 230 of 240 eligible women consented to participate. The 12-month prevalence of depression was 19.1% (95% ci 14.4-24.9). on multivariate analyses, having been educated beyond primary school was protective (or 0.5, 95% ci 0.2-0.9). risk factors were: being divorced or widowed (or 4.9, 95% ci 1.3-18.3); a history of depression before pregnancy (or 7.9, 95% ci 3.1-20.5); loss of an intimate relationship (or 8.4, 95% ci 3.3-21.4), experienced financial difficulties (or 6.6, 95% ci 2.5-17.2) and having been exposed to violence in the previous year (or 4.2, 95% ci 1.5-11.8). Conclusions. Depression is common during pregnancy and is associated with indicators of socio-economic deprivation, violence and the loss of an intimate relationship, and with a previous history of depression. Psychosocial interventions and appropriate social policies need to be implemented in this population to reduce the burden of maternal depression.
107 citations
Cites background from "Intimate partner violence & depress..."
...The association of poverty and violence with depression has been well-documented in developed countries (Ewart & Suchday, 2002; Daniels, 2005; Mezey et al. 2005) and the evidence based on this association from developing countries is growing (e....
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...The association of poverty and violence with depression has been well-documented in developed countries (Ewart & Suchday, 2002; Daniels, 2005; Mezey et al. 2005) and the evidence based on this association from developing countries is growing (e.g. Patel et al. 2002)....
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TL;DR: Intimate partner violence is positively associated with postpartum depression among Canadian women, and implications for healthcare practice are discussed.
99 citations
Cites background from "Intimate partner violence & depress..."
...Recently, Daniels (25) referred to the association between intimate partner violence and depression as a deadly comorbidity because of the established risk of homicide and suicide in the presence of both conditions....
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TL;DR: The findings show that the husbands' PTSD was more strongly associated with the wives' secondary traumatization than their captivity, and in addition to husband's PTSD and captivity, both the man's aggression and the wife's self-disclosure played a role in the Wife's level of distress.
Abstract: Background
The aim of the study is to examine secondary traumatization of wives of former prisoners of war (POWs) as manifested in posttraumatic stress disorder (PTSD) symptoms, additional psychiatric symptoms, and marital adjustment. In addition, it assessed the role of several contributors to the wives' secondary traumatization: the husband's PTSD, the level of his verbal and physical aggression, and the wife's level of self-disclosure.
70 citations
Cites background from "Intimate partner violence & depress..."
...Findings consistently show a significant association between husbands' aggression and their wives' emotional distress, both among general samples [9, 42] and war veterans [6]....
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References
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TL;DR: Notably, major depressive disorder is a common disorder, widely distributed in the population, and usually associated with substantial symptom severity and role impairment, and while the recent increase in treatment is encouraging, inadequate treatment is a serious concern.
Abstract: ContextUncertainties exist about prevalence and correlates of major depressive
disorder (MDD).ObjectiveTo present nationally representative data on prevalence and correlates
of MDD by Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition (DSM-IV) criteria, and on study
patterns and correlates of treatment and treatment adequacy from the recently
completed National Comorbidity Survey Replication (NCS-R).DesignFace-to-face household survey conducted from February 2001 to December
2002.SettingThe 48 contiguous United States.ParticipantsHousehold residents ages 18 years or older (N = 9090) who responded
to the NCS-R survey.Main Outcome MeasuresPrevalence and correlates of MDD using the World Health Organization's
(WHO) Composite International Diagnostic Interview (CIDI), 12-month severity
with the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR),
the Sheehan Disability Scale (SDS), and the WHO disability assessment scale
(WHO-DAS). Clinical reinterviews used the Structured Clinical Interview for DSM-IV.ResultsThe prevalence of CIDI MDD for lifetime was 16.2% (95% confidence interval
[CI], 15.1-17.3) (32.6-35.1 million US adults) and for 12-month was 6.6% (95%
CI, 5.9-7.3) (13.1-14.2 million US adults). Virtually all CIDI 12-month cases
were independently classified as clinically significant using the QIDS-SR,
with 10.4% mild, 38.6% moderate, 38.0% severe, and 12.9% very severe. Mean
episode duration was 16 weeks (95% CI, 15.1-17.3). Role impairment as measured
by SDS was substantial as indicated by 59.3% of 12-month cases with severe
or very severe role impairment. Most lifetime (72.1%) and 12-month (78.5%)
cases had comorbid CIDI/DSM-IV disorders, with MDD
only rarely primary. Although 51.6% (95% CI, 46.1-57.2) of 12-month cases
received health care treatment for MDD, treatment was adequate in only 41.9%
(95% CI, 35.9-47.9) of these cases, resulting in 21.7% (95% CI, 18.1-25.2)
of 12-month MDD being adequately treated. Sociodemographic correlates of treatment
were far less numerous than those of prevalence.ConclusionsMajor depressive disorder is a common disorder, widely distributed in
the population, and usually associated with substantial symptom severity and
role impairment. While the recent increase in treatment is encouraging, inadequate
treatment is a serious concern. Emphasis on screening and expansion of treatment
needs to be accompanied by a parallel emphasis on treatment quality improvement.
7,706 citations
TL;DR: Research on the mental and physical health sequelae of intimate partner violence is reviewed and increased assessment and interventions for intimate partner Violence in health-care settings are recommended.
3,615 citations
01 Nov 2000
2,147 citations
TL;DR: In this paper, a review of the literature on the prevalence of mental health problems among women with a history of intimate partner violence is presented, with a focus on depression and posttraumatic stress disorder (PTSD).
Abstract: This article reviews literature on the prevalence of mental health problems among women with a history of intimate partner violence. The weighted mean prevalence of mental health problems among battered women was 47.6% in 18 studies of depression, 17.9% in 13 studies of suicidality, 63.8% in 11 studies of posttraumatic stress disorder (PTSD), 18.5% in 10 studies of alcohol abuse, and 8.9% in four studies of drug abuse. These were typically inconsistent across studies. Weighted mean odds ratios representing associations of these problems with violence ranged from 3.55 to 5.62, and were typically consistent across studies. Variability was accounted for by differences in sampling frames. Dose-response relationships of violence to depression and PTSD were observed. Although research has not addressed many criteria for causal inferences, the existing research is consistent with the hypothesis that intimate partner violence increases risk for mental health problems. The appropriate way to conceptualize these problems deserves careful attention.
1,703 citations
TL;DR: The test characteristics of a two-question case-fidning instrument that asks about depressed mood and anhedonia were compared with six common case-finding instruments, using the Quick Diagnostic Interview Schedule as a criterion standard for the diagnosis of major depression.
Abstract: Objective
To determine the validity of a two-question case-finding instrument for depression as compared with six previously validated instruments.
1,555 citations