New research from the UK finds that experience of domestic violence is more common among adults with all kinds of mental health disorders than in the general population. The researchers, from King’s College London’s Institute of Psychiatry, and the University of Bristol, say their findings suggest doctors should be aware of the link and ensure patients with mental health problems are kept safe from domestic violence and treated for the mental health effects of such abuse.

They write about their findings in the 26 December issue of the online open access journal PLoS ONE.

The study, a systematic review and meta-analysis of published data, is part of PROVIDE, a 5-year research program on domestic violence funded by the National Institute for Health Research (NIHR).

Previous research on the link between mental health problems and domestic violence have tended to focus mainly on depression.

For this new review and analysis, the reseachers pooled data from 41 studies worldwide to estimate the prevalence and odds of men and women with various kinds of mental health disorders being victims of domestic violence.

They found, for example, that:

  • Compared to women with no mental health disorders, measured over their adult life, women with depressive disorders were around 2.5 times more likely to have been victims of domestic violence (with a prevalence estimated at 45.8%).
  • For women with anxiety disorders, this figure was over 3.5 times, with a prevalence estimate of 27.6%.
  • And women with post-traumatic stress disorder (PTSD), the chances of having experienced domestic violence was 7 times more (prevalence estimate 61.0%) than women with no mental health problems.

Women with other mental health diagonoses, such as eating disorders, obsessive compulsive disorder (OCD), schizophrenia, bipolar disorder, and common mental health problems, were also more likely to have experienced domestic violence compared to women with no mental health diagnoses.

For men there was a similar pattern. Compared with men with no mental health diagnoses, men with all types of mental disorders were also more likely to have been victims of domestic violence, except that prevalence estimates were much lower than for women, suggesting it is much less common for men to be at the receiving end of repeated severe domestic abuse than women.

Senior author Louise Howard, a professor at King’s Institute of Psychiatry, says in a statement that the study finds both men and women with mental health problems are also the ones at increased risk for domestic abuse, meaning that:

“The evidence suggests that there are two things happening: domestic violence can often lead to victims developing mental health problems, and people with mental health problems are more likely to experience domestic violence.”

“Mental health professionals need to be aware of the link between domestic violence and mental health problems, and ensure that their patients are safe from domestic violence and are treated for the mental health impact of such abuse,” she urges.

Worldwide estimates suggest over their lifetime, betwee 15 and 71% of women experience physical or sexual violence from a partner.

Figures from the 2010-11 British Crime Survey estimate 27% of women and 17% of men in the UK experience abuse from their partner during their lifetime, with women being more likely to experience repeated and severe violence than men.

The definition of domestic violence in the UK is about to change, and will also include those aged 16 and 17. From March 2013, the Home Office will be defining domestic violence as:

“… any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This can encompass, but is not limited to, psychological, physical, sexual, financial or emotional abuse.”

Co-author Gene Feder, a professor at University of Bristol’s School of Social and Community Medicine, and chief investigator of PROVIDE, says:

“We hope this review will draw attention to the mental health needs of survivors of domestic violence and remind general practitioners and mental health teams that experience of domestic violence may lie behind the presentation of mental health problems.”

The authors also call for more studies that follow people with mental disoders to identify the different ways they can end up being victims of domestic abuse. Such findings could, for example, help design better healthcare services.

In 2011, Feder co-authored an article published in The Lancet that showed GPs and nurses who are trained to ask patients about domestic violence, and how to refer them easily to advocacy organizations, are 22 times more likely to document referral of women suffering domestic abuse compared to those without training.

Written by Catharine Paddock PhD