A study in the August 3 issue of JAMA, a theme issue on violence and human rights, revealed that women who suffered gender-based violence, such as rape, sexual assault, intimate partner violence and stalking, had a higher associated lifetime ratio of mental health disorders, dysfunction and disability. The article’s background information states that violence against women is a major public health concern, contributing to high levels of illness and death worldwide.

According to the author, 17% of women in the United States report rape or attempted rape and more than one-fifth of women report intimate partner violence (IPV), stalking, or both. The author states that there is increasing evidence that each of these types of gender-based violence (GBV) is connected to mental disorder among women, although methodological insufficiency of existing studies constrain from drawing conclusions.

The association of a complex index of GBV (rape, sexual abuse, IPV, and stalking) in conjunction with various lifetime mental disorders, including levels of severity and co-existing illnesses was assessed by Susan Rees, Ph.D., of the University of New South Wales, Sydney, New South Wales, and her colleagues.

The research was conducted with data from the Australian National Mental Health and Well-being Survey of 2007 with a response rate of 65% and included 4,451 women aged between 16 to 85 years.

To assess lifetime prevalence of any mental disorder, anxiety, mood disorder, substance use disorder and posttraumatic stress disorder (PTSD), researchers used diagnostic criteria from the World Health Organization’s World Mental Health Survey Initiative.

They discovered that the lifetime prevalence for any mental disorder was 37.8%, with 27.4% (a total of 1,218 women) stating to have experienced at least 1 of the types of GBV assessed in this study. The lifetime prevalence rates concluded in 14.7% for sexual assault, 10% for stalking, 8.1% for rape and 7.8% for IPV.

Furthermore, it was revealed that women who were exposed to 1 form of GBV reported high rates of lifetime mood disorder (weighted, 30/. 7%), with 38.5% of women suffering from a lifetime anxiety disorder, 23.0% a lifetime substance use disorder, 15.2% of lifetime PTSD, and any lifetime mental disorder of 57.3%.

The link was especially strong for women who had experienced exposure to 3 to 4 forms of GBV. Figures revealed that 77.3% had a lifetime anxiety disorder, 52.5% a lifetime mood disorder, 47.1% a lifetime substance disorder, 56.2% lifetime PTSD, and any lifetime mental disorder of 89.4%. Suicide attempts for women exposed to a single GBV was increased by 6.6% (weighted) rising to a staggering rate of 34.7% for those exposed to 3 to 4 types of GBV.

Research also discovered that GBV was linked to more severe current mental disorder, higher rates of 3 or more lifetime disorders, physical and mental disability, impaired life quality, a rise in disability days and general disability.

The authors state:

“Our data underline the observation that mental health disorder in women who have experienced GBV tends to be more severe and associated with the presence of one or more disorders, characteristics that require expert and comprehensive approaches to treatment. Therefore, there is a need to ensure that expert mental health care is a central component of GBV programs.

Similarly, psychiatric services need to be better equipped to assist women with mental health disorders who have experienced GBV. In general, a renewed drift is required to develop an evidence base for prevention and clinical interventions that reflect a comprehensive view of GBV and its association with wide-ranging mental and psychosocial disabilities among women.”

Written by Petra Rattue