Mental Disorders Linked With Domestic Violence, Study Says

By Randy Dotinga Wednesday, January 2, 2013 

WEDNESDAY, Jan. 2 (HealthDay News) -- People diagnosed with mental illness are more likely than others to be victims of domestic violence, a new analysis finds.

Previous research has linked depression to domestic violence, but this review looks at a possible link between mental illness overall and domestic abuse in men and women.

"In this study, we found that both men and women with mental health problems are at an increased risk of domestic violence," senior study author Louise Howard, a professor at King's College London's Institute of Psychiatry, said in a college news release.

"The evidence suggests that there are two things happening: Domestic violence can often lead to victims developing mental health problems, and people with mental health problems are more likely to experience domestic violence," Howard said.

The review, published recently in the journal PLoS One, examines statistics from 41 studies worldwide. It finds that women with symptoms of depression were 2.5 times more likely to have experienced domestic violence over their lifetimes than those in the general population, while those with anxiety disorders were more than 3.5 times more likely to have suffered domestic abuse. The extra risk grew to seven times more likely among those with post-traumatic stress disorder.

Women with other conditions, such as obsessive compulsive disorder, eating disorders, schizophrenia and bipolar disorder were also at higher risk, as were men with all types of mental disorders.
"Mental health professionals need to be aware of the link between domestic violence and mental health problems, and ensure that their patients are safe from domestic violence and are treated for the mental health impact of such abuse," said Howard.

Domestic abuse can be physical, psychological, sexual, financial or emotional and include overly controlling or coercive behavior.

SOURCE: King's College London, England, news release, Dec. 26, 2012

Copyright (c) 2013 HealthDay. All rights reserved.

Violence Against Women Can Take Lifelong Toll: Study Released

Research shows how rates of mental and physical illness rise, quality of life falls

By Serena Gordon
HealthDay Reporter
TUESDAY, Aug. 2 (HealthDay News) -- Women who've suffered from gender-based violence are more likely to develop anxiety disorders or other mental woes, experience physical and mental disabilities, and have worse quality of life than other women, new research shows.

Gender-based violence includes rape and other forms of sexual assault, intimate-partner violence (such as spouse abuse) and stalking.

Risks for these long-term problems rose with the intensity of abuse. For example, women who'd experienced three or four types of gender-based violence had 10 times the odds of developing an anxiety disorder than women who haven't experienced such violence, the study found. The odds of a woman who'd been subjected to such violence developing a substance abuse problem were almost six times higher than for a woman who hasn't experienced gender-based violence.

"Gender-based violence is a public health problem and occurs to many women. Women need to recognize that the social and psychological problems they are experiencing may be related to their past or current exposure to violence and not pass these reactions off to other causes," said the study's lead author, Susan Rees, a senior research fellow at the University of New South Wales in Sydney, Australia.

Results of the study are published in the Aug. 3 issue of the Journal of the American Medical Association.
In the United States, more than 20 percent of women have experienced intimate-partner violence, stalking or both. A full 17 percent have reported rape or attempted rape, according to background information in the study.

The data for Rees' study came from a national survey done in Australia on mental health and well-being. The survey included over 4,400 women between the ages of 16 and 85 years old.

In that group, 1,218 women (27 percent) reported experiencing at least one form of gender-based violence, while 139 had been exposed to three or more forms of gender-based violence.

The average age that women were first raped was 13 years old and 12 years old for sexual assault. The average age that women were beaten by a partner or stalked was 22 years old.

The more violence a woman was exposed to, the greater her risk of developing mental illnesses, according to the study.

For example, about 15 percent of women who had been subjected to one form of gender-based violence experienced post-traumatic stress disorder (PTSD). But, if women were subjected to three or more forms of gender-based violence, that number jumped to more than 56 percent, the investigators found.

Suicide rates were significantly higher for women who'd experienced gender-based violence. The average rate of attempted suicide was 1.6 percent for all women in the study, but it was 6.6 percent for women who'd experienced one form of violence, and 34.7 percent for women exposed to three or more types of violence.

Rates of physical and mental disabilities were also much higher for women who had experienced gender-based violence. These women also tended to report an impaired quality of life.

Even though the study team had expected the findings, "the extent and strength of the associations we found was surprising and very concerning," Rees said.

She noted that "the nature of gender-based violence is particularly insidious because it occurs in the very situations where the victim/survivor usually expects to enjoy conditions of safety, security and love, particularly the home."

Furthermore, this type of aggression "often occurs repeatedly, unlike other traumas such as exposure to natural disasters, so you get a compounding effect. Gender-based violence is unfortunately still largely considered a personal and private matter, making help-seeking very difficult for many women, so they rarely received the support trauma survivors need to assist recovery," Rees noted.

One U.S. expert said the findings need to be heeded closely.

"This study really demonstrated the extent of gender-based violence and the long-term consequences of violence against women," said Andrea Gielen, director of the Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health in Baltimore. "There are huge implications for health services; this is not just a one-time treatment in the ER for a broken bone. People who treat women for any health-related issues need to think about the extent that such violence can affect women," Gielen said.

Gielen added that in the United States, a measure of help is on the way. The federal government on Monday adopted recommendations from the Institute of Medicine on preventive services for women's health, and one new rule is that health care insurers must cover the cost of screening and counseling for domestic violence.
"Any woman is who experiencing gender-based violence needs to realize that there are things she can do, there are hotlines she can call, there are resources available," Gielen said. "Talking about the experience with an informed and supportive health professional is a good thing to do to move on."

More information
The U.S. Department of Health and Human Services Office on Women's Health has advice on how to help a friend who's being abused.

SOURCES: Susan Rees, Ph.D., Australian Research Council QE-11 Senior Research Fellow, Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, Australia; Andrea Gielen, Sc.D., director, Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore; Aug. 3, 2011, Journal of the American Medical Association
 
Last Updated: Aug. 02, 2011
Copyright © 2011 HealthDay. All rights reserved.

Abuse History More Common in Those With Pelvic Pain, CFS, and Fibromyagia

by The Annapolis Chronic Fatigue and Fibromyalgia Research Center. 
Although the research findings are mixed, I have found a history of abuse to be common in my CFS/FMS patients. In one study, exposure to childhood trauma was associated with a 6-fold increased risk of CFS and this was associated with the stress hormone changes seen in CFS (see abstract below). And as many as 70% have suffered physical or emotional abuse-as opposed to 15% of healthy people and 45% of those with other rheumatologic problems.¹ In another study, 18-33% of patients with Interstitial Cystitis had a history of sexual abuse.²
 
We have also seen in our practice that the pelvic pain , is sometimes associated with hysterectomy at a young age associated with a history of childhood sexual abuse, with the psyche seemingly trying to create a "clean sweep" of the pelvic area surgically.

Meanwhile, physicians continue this abuse pattern by invalidating and not adequately treating the medical problems that can occur downstream from abuse issues, and treating women with these severe processes like they are crazy. It is like treating people with crushing chest pain and a massive heart attack like they were crazy because hostility and depression are associated with an increased heart attack risk.

Whether or not associated with a history of abuse, or whether or not CFS/FMS are also present, pelvic pain can be a major problem, and deserves to be treated. So whether it is vaginal pain (e.g., vulvodynia) or bladder pain (e.g., interstitial cystitis), here is information on pelvic pain in women that can help ease the pain.

Study Abstract

Childhood Trauma and Risk for Chronic Fatigue Syndrome: Association With Neuroendocrine Dysfunction

Journal: Arch Gen Psychiatry. 2009;66(1):72-80
Authors: Christine Heim, PhD; Urs M. Nater, PhD; Elizabeth Maloney, MS, DrPH; Roumiana Boneva, MD, PhD; James F. Jones, MD; William C. Reeves, MD, MSc
Author Affiliations: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine (Drs Heim and Nater), and Chronic Viral Diseases Branch, National Center for Zoonotic, Vector-borne, and Enteric Diseases, Centers for Disease Control and Prevention (Drs Nater, Maloney, Boneva, Jones, and Reeves), Atlanta, Georgia

Context
Childhood trauma appears to be a potent risk factor for chronic fatigue syndrome (CFS). Evidence from developmental neuroscience suggests that early experience programs the development of regulatory systems that are implicated in the pathophysiology of CFS, including the hypothalamic-pituitary-adrenal axis. However, the contribution of childhood trauma to neuroendocrine dysfunction in CFS remains obscure.

Objectives
To replicate findings on the relationship between childhood trauma and risk for CFS and to evaluate the association between childhood trauma and neuroendocrine dysfunction in CFS.

Design, Setting, and Participants
A case-control study of 113 persons with CFS and 124 well control subjects identified from a general population sample of 19 381 adult residents of Georgia.

Main Outcome Measures
Self-reported childhood trauma (sexual, physical, and emotional abuse; emotional and physical neglect), psychopathology (depression, anxiety, and posttraumatic stress disorder), and salivary cortisol response to awakening.

Results
Individuals with CFS reported significantly higher levels of childhood trauma and psychopathological symptoms than control subjects. Exposure to childhood trauma was associated with a 6-fold increased risk of CFS. Sexual abuse, emotional abuse, and emotional neglect were most effective in discriminating CFS cases from controls. There was a graded relationship between exposure level and CFS risk. The risk of CFS conveyed by childhood trauma further increased with the presence of posttraumatic stress disorder symptoms. Only individuals with CFS and with childhood trauma exposure, but not individuals with CFS without exposure, exhibited decreased salivary cortisol concentrations after awakening compared with control subjects.

Conclusions
Our results confirm childhood trauma as an important risk factor of CFS. In addition, neuroendocrine dysfunction, a hallmark feature of CFS, appears to be associated with childhood trauma. This possibly reflects a biological correlate of vulnerability due to early developmental insults. Our findings are critical to inform pathophysiological research and to devise targets for the prevention of CFS.

References

¹Castro I, Barrantes F, Tuna M, Cabrera G, Garcia C, Recinos M, Espinoza LR, Garcia-Kutzbach A. Prevalence of Abuse in Fibromyalgia and Other Rheumatic Disorders at a Specialized Clinic in Rheumatic Diseases in Guatemala City. Clin Rheumatol. 2005 Jun;11(3):140-145.
²J Urol. 2008 Nov; 180(5):2029-33 10.1016/j.juro. 2008.07.053