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Intimate partner violence (IPV) against women is alarmingly common and widely understood to be a risk factor for both mental and physical problems. However, most research in this area has been conducted in developed countries and in clinical rather than community populations, has used small samples, has not used standard definitions of violence, and has not controlled for confounders. Therefore, the World Health Organization sponsored a methodologically rigorous, population-based survey of 24,097 women (age range, 15–49; 97% of those eligible) at 15 rural and urban sites in 10 countries in South America, Africa, and Asia.
This report is an analysis of responses from the 19,568 women who ever had a male partner. Findings were adjusted for age, marital status, and education. Lifetime experience of physical or sexual violence ranged from 15% to 71% across countries and was associated with significantly more reports of current poor physical health, pain, difficulty with daily activities, memory loss, dizziness, vaginal discharge, and emotional distress. The strongest association was between IPV and suicide attempts (odds ratio, 3.8).
Ellsberg M et al. Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: An observational study. Lancet 2008 Apr 5; 371:1165.
Comment
This important study documents the negative health effects of IPV in non-Western countries. These findings are similar to those reported in the U.S. and western Europe, confirming that IPV is a major problem worldwide and is associated with morbidity and mortality. For obvious reasons, the study did not address rates of completed suicide and homicide among female victims of IPV. Clinicians need to be aware of the possibility of IPV among female patients and need to address the issue in their treatment. In managing this issue, clinicians also need to remember that leaving an offending partner increases risk for homicide.