Summary: Women who experience interpersonal violence from their partners are three times as likely to develop a mental health problem, including schizophrenia and bipolar disorder. Not only did researchers find a higher chance of developing a mental illness following domestic abuse, but also discovered those with a mental health problem were more likely to experience abuse in future relationships.
Source: University of Birmingham
Academics at the University of Birmingham have identified a significant association between mental illness and domestic abuse in UK women.
Up until now, there has been confusion whether the mental illness or the abuse came first and very few previous studies have been able to demonstrate the direction of the relationship.
This new study is the first of its kind in the UK to clearly show that the relationship runs both ways and the key findings were:
- those experiencing domestic abuse are nearly three times as likely to develop mental illness;
- women who are experiencing domestic abuse are also nearly three times more likely to have a history of mental illness;
- this is the first study to show the link between domestic abuse and serious mental illness (bipolar and schizophrenia);
- there is a huge discrepancy found between the abuse reported in GP practices and the national data, showing significant under-reporting.
The study, published in the British Journal of Psychiatry, found that not only was there a higher chance of developing mental illness after experiencing domestic abuse, but those with mental illness were more likely to go on to experience further domestic abuse.
Using medical records from UK GP surgeries between 1995 and 2017, researchers have been able to build a narrative of women within the large database before and after experiencing domestic abuse.
The authors identified 18,547 women who had experienced domestic abuse, recorded by their GP. They compared these women to a control group of 74,188 similarly aged women who had not had experience of domestic abuse recorded.
It is the first of its kind in the UK because it is a cohort study, which is a study where people are followed up over time from the point where they have experienced trauma until the point they develop mental illness.
During the final year of the study in 2017, the reported prevalence of domestic abuse was only 0.5% for women in the database. However, the Office for National Statistics estimates this figure should be closer to in 1 in 4 women experiencing domestic abuse at any point in their lifetime. It is apparent from this study, therefore, that domestic abuse is under-recorded by GPs. It is imperative within the public sector to use all possible opportunities to detect abuse and to ensure at-risk women have the chance to receive the support they need.
The association of poor mental health (depression and anxiety) after experiencing domestic abuse in women has been shown in other countries. However, the extent of this has not been explored in a large population within the UK, and neither has the relationship between domestic abuse and serious mental illness (schizophrenia and bipolar disorder). Researchers found that experiencing domestic abuse led to a doubling of the risk of developing anxiety, and a tripling of the risk of developing depression and serious mental illness even when accounting for other factors that lead to mental illness.
It was clear at the starting point of the study that 49.5% of women who had presented to their GP with domestic abuse had already had some form of mental illness diagnosed by the GP, compared to the control group of whom 24.0% had a pre-existing diagnosis of mental illness. After accounting for other factors that could influence the likely development of mental illness and domestic abuse, this translated in a nearly triple risk of domestic abuse survivors having had a mental illness before they were included in the study.
The authors then excluded these patients who had a mental illness at the start of the study and followed up the remainder of patients to ascertain their risk of developing a new mental illness.
The research raises several important questions and recommendations. Considering how common domestic abuse is, the public mental health burden that follows such abuse is vast within the UK. There needs to be a greater focus on the implementation of a public health approach to protect women against abuse.
For those who have experienced abuse, we need to promote the delivery and implementation of services which aim to reduce the follow-on effects of abuse on mental wellbeing.
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