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David Baxter

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Domestic violence increases psychiatric disorders in women

Being in an abusive relationship appears to be associated with an increase in psychiatric disorders among women but not among men.

"Numerous studies have documented higher levels of physical injury among female compared to male partners in abusive relationships and greater fear in female partners, even if the abusive relationship is known to be bi-directional," note Miriam Ehrensaft (Columbia University, New York, USA) and colleagues.

"The present study extends this important sex difference to the mental health consequences of abuse."

The researchers investigated the prevalence of partner abuse among 1037 individuals, who were assessed for mental health disorders at 18 years of age.

In all, 38 women and 37 men were involved in abusive relationships between the ages of 24 and 26 years, which resulted in injury and/or official intervention.

Women in abusive relationships, compared with their peers who were not, had significantly higher rates of major depression and marijuana dependence at age 18 years, with odds ratios of 2.62 and 3.21, respectively.

Similarly, men who were involved in abusive relationships, were 3.02 times more likely to have major depression at the age of 18 years and 5.28 times more likely to have marijuana dependence than men in nonabusive relationships. They were also more likely to have had alcohol dependence and any anxiety disorder, at odds ratios of 2.30 and 2.42, respectively.

A continuity of psychiatric disorders was apparent for both men and women, with 32% of women involved in clinical abuse having two or more psychiatric diagnoses at age 26 years, compared with 9% of women not involved in clinical abuse. The corresponding figures for men were 27% and 11%, respectively.

Reporting in the American Journal of Psychiatry, the researchers note, however, that after taking into account the earlier psychiatric history of the participants, clinical partner abuse was only significantly associated with current psychiatric disorders in women and not men.

Involvement in a clinically abusive relationship predicted women's risk at age 26 years of major depressive episodes, marijuana dependence, and post-traumatic stress disorder even after controlling for the same diagnosis at 18 years of age.

"This present study suggests that partner abuse is a contributing source of psychiatric disorders among women of childbearing age," say Ehrensaft et al.

They add: "Partner abuse should be assessed routinely during psychiatric evaluations.

"If partner abuse is ongoing and is not treated, important opportunities may be missed to improve women's psychiatric prognosis."

Am J Psychiatry 2006; 163: 885-892
 

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