The links between domestic violence and mental health are well documented. Research shows that people who are suffering from mental health problems may be more vulnerable to domestic violence. Studies also suggest that domestic violence may increase the risk of mental illness and that continued violence may lead to more persistent ill health.

However, we know very little about the prevalence of domestic violence, because previous studies have been of quite poor quality and have not appraised the validity and applicability of the primary research they have included. What we do know is mostly about the prevalence of domestic violence in women, as previous reviews have tended to neglect violence committed towards men.

A new systematic review published in the British Journal of Psychiatry aims to estimate the prevalence (adult lifetime and past year) of different types of domestic violence experienced by men and women receiving psychiatric treatment.

Methods

The reviewers from the Institute of Psychiatry and the University of Bristol searched for different sorts of experimental studies that either measured the prevalence or risk of adult lifetime and/or past year domestic violence, or included data from which these statistics could be calculated.

Studies included psychiatric patients (men or women) aged 16 or older, who were receiving care in inpatient, outpatient or community-based settings.

Domestic violence was defined as:

Any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are or have been intimate partners or family members regardless of gender or sexuality. (Home Office, 2005)

The reviewers identified over 40,000 references from their searching and eventually whittled the number down to 42 studies that were included in their review.

The vast majority of the included studies (86%) reported on domestic violence perpetrated by an intimate partner only. A minority of the included studies (14%) reported on violence perpetrated by either an intimate partner or other family member. 76% of studies measured lifetime experiences of domestic violence only.

None of the included studies had a control group.

Results

• The review found a high prevalence of domestic violence experiences in psychiatric patients
• In women, the prevalence of lifetime partner violence was:
  • 30% in inpatients
  • 33% in outpatients
• In men, the prevalence of lifetime partner violence was:
  • 18% across all settings

Conclusions

The authors concluded:

Psychiatric patients experience a high prevalence of domestic violence but there is limited information on family (non-partner) domestic violence, the prevalence of emotional abuse and the extent of risk compared with non-psychiatric controls.

This well conducted review adds to what we know, but it also highlights a continued gap in the evidence regarding domestic violence among psychiatric populations. Further studies are needed that compare psychiatric patients’ risk of domestic violence with that of other clinical populations or the general population.

It’s also worth noting that the same authors published a very similar review (Trevillion, 2012) in the open-access PLoS ONE journal, which included one study less in the analysis. That review aimed to estimate the prevalence and odds of being a victim of domestic violence by diagnostic category and sex. The results of that review included these findings:

Compared to women without mental disorders, there is a higher risk of experiencing adult lifetime partner violence among women with:

• Depressive disorders (OR 2.77 (95% CI 1.96–3.92)
• Anxiety disorders (OR 4.08 (95% CI 2.39–6.97)
• PTSD (OR 7.34 95% CI 4.50–11.98)

Links

Oram S, Trevillion K, Feder G and Howard LM. Prevalence of experiences of domestic violence among psychiatric patients: systematic review. Br-J-Psych 2013, 202:94-99. DOI: 10.1192/bjp.bp.112.109934 [Abstract]

Trevillion K, Oram S, Feder G, Howard LM. Experiences of Domestic Violence and Mental Disorders: A Systematic Review and Meta-Analysis. PLoS ONE 2012, 7(12): e51740. doi:10.1371/journal.pone.0051740

Home Office. Domestic Violence: A National Report: 7. UK Home Office, 2005.