SeriesHealth consequences of intimate partner violence
Section snippets
Health-care settings
In investigations in health-care settings (mainly from the USA), yearly prevalence of intimate partner violence has varied between 4 and 23%, with middle-level socioeconomic and well educated groups having the lowest prevalence, and poorer women the highest (figure 1).1, 3 Intimate partner violence might be higher in health-care settings than in most US populationbased samples because samples would be expected to include a substantial proportion of battered women. Furthermore, the same studies
Physical health effects
Women who are abused are frequently treated within health-care systems, however, they generally do not present with obvious trauma, even in accident and emergency departments.3 Intimate partner violence has long-term negative health consequences for survivors, even after the abuse has ended.4, 5 These effects can manifest as poor health status, poor quality of life, and high use of health services.6, 7, 8 Battering is a significant direct and indirect risk factor for various physical health
Forced sex
Gynaecological problems are the most consistent, longest lasting, and largest physical health difference between battered and non-battered women. Differential symptoms and conditions include sexually-transmitted diseases, vaginal bleeding or infection, fibroids, decreased sexual desire, genital irritation, pain on intercourse, chronic pelvic pain, and urinary-tract infections.5, 6, 8, 22, 23, 24, 25, 27, 30, 31, 32 In one of the best-sampled (good sampling techniques, high representation, good
Abuse during pregnancy
In a large review of US studies of prevalence of abuse during pregnancy, Gazmararian and colleagues44 noted a range of 0·9–20·1%; in most studies a range of 3·9–8·3% was recorded. Prevalence of such abuse in other industrialised and non-industrialised nations are similar: 6·4% during the past year and 2·5% overall in the UK (7·8% including threats),45 5·5–6·6% in Canada,46, 47 at least 6·8% in South Africa,48 11% in Sweden (21% including symbolic violence and threats),49 and 13% in Nicaragua.50
Mental-health effects
Depression and post-traumatic stress disorder, which have substantial comorbidity, are the most prevalent mental-health sequelae of intimate partner violence (figure 3).2, 8, 20, 65, 66, 67, 68, 69 In a comprehensive meta-analysis of mainly US studies, Golding20 showed that the risk for depression and post-traumatic stress disorder associated with intimate partner violence was even higher than that resulting from childhood sexual assault. Depression in battered women has also been associated
Use of medical care
Analysis of the relations between partner abuse, health status, and use of medical care in women in population-based and clinical studies has shown poorer overall mental and physical health, more injuries, and more consumption of medical care including prescriptions and admissions to hospital in abused than non-abused women.5, 6, 7, 22 In a Canadian population-based study,2 battered women sought care from accident and emergency departments and saw a medical professional about 3 times more often
Conclusions
Battered women present in all health-care settings with many different physical and mental-health problems and demographic characteristics. Women may present to health-care settings before they present to criminal justice or social service agencies, and if abuse is identified they can receive interventions that increase their safety and improve their health. Thus, assessment for intimate partner violence of all women should be done in all health-care settings;77 several studies have validated
References (82)
- et al.
Mental and physical health effects of intimate partner violence on women and children
Psychiatr Clin North Am
(1997) - et al.
Health indicators and intimate partner violence among women who are members of a managed care organization
Prev Med
(1999) - et al.
Violent maternal deaths in North Carolina
Obstet Gynecol
(1999) - et al.
Gynecologic health consequences to victims of interpersonal violence
Womens Health Issues
(1999) - et al.
The intersection of HIV and violence: directions for future research and interventions
Soc Sci Med
(2000) - et al.
The prevalence of domestic violence among women seeking abortion
Obstet Gynecol
(1998) - et al.
Domestic violence and health of Pakistani women
Internat J Gynaecol Obstet
(1999) - et al.
Annual and lifetime prevalence of partner abuse in a sample of female HMO enrollees
Womens Health Issues
(1999) The incidence of wife abuse and mental health status in abused wives in Edmonton, Alberta
Can J Public Health
(1993)- et al.
Prevalence of domestic violence in women treated at community hospital emergency department
JAMA
(1998)
Deleterious effects of criminal victimization on women's health and medical utilization
Arch Intern Med
Intimate partner violence against women: do victims cost health plans more?
J Fam Pract
The “battering syndrome”: prevalence and clinical characteristics of domestic violence in primary care internal medicine practices
Ann Intern Med
Violence-related injuries treated in hospital emergency departments. Bureau of Justice Statistics special report
Violent injuries among women in an urban area
N Engl J Med
Risk factors for injury to women from domestic violence against women
N Engl J Med
Violence against women: estimates from the redesigned survey
Intimate femicide in Ontario, 1991–1994
When men murder women: an analysis of 1997 homicide data—females murdered by males in single victim/single offender incidents
The victims of homicide: a temporal and cross national comparison
Am Soc Rev
Ending violence against women
Popul Rep L
Female suicide and wife abuse in cross cultural perspective
Suicide Life Threat Behav
Suicide attempts by battered wives
Acta Psychiatr Scand
Intimate partner violence as a risk factor for mental disorders: a meta-analysis
J Fam Viol
Domestic violence against patients with chronic neurologic disorders
Arch Neurol
Selected symptoms associated with sexual and physical abuse among female patients with gastrointestinal disorders: the impact on subsequent health care visits
Psychol Med
Physical health consequences of physical and psychological intimate partner violence
Arch Fam Med
Violence and abuse: implications for women's health
The role of alcohol use in intimate partner femicide
Am J Addictions
Sexual and physical abuse and gastrointestinal illness: review and recommendations
Ann Intern Med
The long-term effects of battering on women's health
Womens Health Res Gen Behav Pol
Forced sex and intimate partner violence: effects on women's health
Violence Against Women
Gynaecological impact of sexual and physical abuse by spouse: a study of a random sample of Norweigian women
Br J Obstet Gynaecol
A comparative study of women with chronic pelvic pain, chronic nonpelvic pain and those with no history of pain attending general practitioners
Br J Obstet Gynaecol
Violence against women in Sierra Leone: frequency and correlates of intimate partner violence and forced sexual intercourse
Afr J Reprod Health
Violence, rape, and sexual coercion: everyday love in a South African township
Gender Dev
The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women
Am J Public Health
Women, violence and HIV/AIDS in Zimbabwe
SAfAIDS
Sexual behaviors and reproductive health outcomes: associations with wife abuse in India
JAMA
Cited by (2859)
Screening for Intimate Partner Violence in Trauma: Results of a Quality Improvement Project
2024, Journal of Surgical ResearchEmpowering Survivors of Intimate Partner Violence: The Role of Advanced Practice Nurses
2024, Journal for Nurse Practitioners