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Link between domestic violence and perinatal mental health disorders

Women who have mental health disorders around the time of birth are more likely to have previously experienced domestic violence, according to a study by King’s College London and the University of Bristol.

The researchers found that high levels of symptoms of perinatal depression, anxiety, and post-traumatic stress disorder were linked to having experienced domestic violence either during pregnancy, the past year, or over a woman’s lifetime.

The researchers reached these conclusions by reviewing 67 relevant studies (in a systematic review) and combining the results. The findings are published today in PLOS Medicine.

They found that around 12-13% of postnatal depression (i.e. high levels of postnatal depressive symptoms) is linked with experiences of domestic violence during pregnancy. In a further analysis, the authors found that women with antenatal and postnatal depression were three times more likely to have experienced domestic violence in the past year and 5 times more likely to have experienced domestic violence when pregnant. Women with antenatal anxiety disorders were also three times more likely to have experienced domestic violence over her lifetime but this figure was less in women with postnatal anxiety disorders.

However, it is important to note that these findings cannot prove that domestic violence can cause perinatal mental health disorders or provide evidence that perinatal mental health disorders can lead to subsequent domestic violence, and there is no information on other perinatal mental disorders, such as eating disorders and puerperal psychosis.

Professor Louise Howard, lead author of the study published in PLOS Medicine and head of women’s mental health at King’s College London’s Institute of Psychiatry, says: “Women with postnatal mental health problems, such as symptoms of depression, anxiety and post-traumatic stress disorder, have an increased likelihood of having experienced domestic violence at some point in their lives. Both domestic violence and antenatal and postnatal mental health problems carry risks to the mother and child, during pregnancy and in the postpartum period. Our study highlights the importance of identifying and responding to possible cases of domestic violence among all women, especially if they are pregnant.”

Professor Gene Feder, from the University of Bristol: “Our study emphasizes the importance of identifying and responding to possible domestic violence among women attending maternity, primary care and mental health services and highlights the need for further research on  how health services should respond to  domestic violence and improve health outcomes for women and their infants in the future.”

The study was funded by a National Institute for Health Reasearch Programme Grants for Applied Research scheme

Paper reference: Howard LM et al. ‘Domestic Violence and Perinatal Mental Disorders: A Systematic Review and Meta-Analysis’ PLoS Medicine doi:10.1371/journal.pmed.1001452

Professors Louise Howard and Gene Feder are editors of a new book for mental health professionals: ‘Domestic Violence & Mental Health’, written with their colleague Dr Roxane Agnew-Davies and published by the Royal College of Psychiatrists.

For further information, please contact Louise Pratt, PR & Communications Manager, Institute of Psychiatry, King’s College LondonEmail: Tel: (+44) 0207 848 537