The risk of depression and Post Traumatic Stress Disorder (PTSD) associated with intimate partner violence is higher than the risk of these disorders resulting from childhood physical and sexual abuse.
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This is according to a paper presented by Dr Soraya Seedat of the MRC Unit on Anxiety and Stress Disorders at the 12th National Psychiatry Congress in Somerset West.
American studies have shown that the incidence of PTSD amongst women in battered/sheltered populations ranges from 33% to 84%.
In the South African setting, PTSD and depression have also been documented to be significantly more common in patients with a history of intimate partner violence (35%) than in non-abused women (3%). The rate of depression was also considerably higher - 48% in abused women compared with 11% in non-abused women.
In addition to depression and PTSD, alcohol and drug abuse are also common consequences.
According to Dr Seedat, studies have shown that intimate partner violence may also be associated with long-term physical health problems: overall health is poorer and abused women report more central nervous system problems (such as headaches and back pain), gynaecological problems (pelvic pain, vaginal infection, vaginal bleeding and painful intercourse) and chronic stress-related problems (such as loss of appetite, digestive problems and abdominal pain).
“Primary care practitioners, in particular, need to have a high index of suspicion and should routinely screen women for intimate partner violence as there are now well validated brief clinical screens that can be used,” said Dr Seedat.
Intimate partner violence common
In the past 16 years more than 50 large surveys have been done globally. These studies indicate that between 10% and 50% of women have been physically assaulted by an intimate partner at some point in their lives and between 3% and 52% have been physically assaulted in the previous year.
The first major community-based prevalence study in South Africa was conducted last year. Researchers sampled women aged 18 to 49 years in 2 232 randomly selected households in the Eastern Cape, Mpumalanga and Northern Province. This study found that the combined rates across these three places of having been physically abused by a current or ex-partner in the last year, were much higher than the rate of having been raped in the last year.
What puts women at risk for intimate partner violence?
According to Dr Seedat, several studies have identified risk factors such as ethnicity (Blacks tend to be at higher risk than Whites), low income, divorce or separation, history of mental disorder in the woman and/or her partner, alcohol/drug abuse in the woman and/or her partner, and physical and sexual abuse in childhood.
“There may also be biological risk factors,” said Dr Seedat. She did a study to look at the endocrine profile of women with intimate partner violence and found that women had significantly lower cortisol levels (a stress hormone) compared with non-abused women. - (Ilse Pauw, health24)
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