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Domestic violence and severe psychiatric disorders: prevalence and interventions

Published online by Cambridge University Press:  06 November 2009

L. M. Howard*
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK
K. Trevillion
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK
H. Khalifeh
Affiliation:
University College London, Department of Mental Health Sciences, Royal Free Hospital School of Medicine, London, UK
A. Woodall
Affiliation:
Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK
R. Agnew-Davies
Affiliation:
Institute of Primary Care and Public Health, London South Bank University, UK
G. Feder
Affiliation:
Academic Unit of Primary Health Care, University of Bristol, UK
*
*Address for correspondence: Dr L. M. Howard, Section of Women's Mental Health, Health Service and Population Research Department, PO31 Institute of Psychiatry, King's College London, De Crespigny Park, LondonSE5 8AF, UK. (Email: Louise.howard@kcl.ac.uk)

Abstract

Background

The lifetime prevalence of domestic violence in women is 20–25%. There is increasing recognition of the increased vulnerability of psychiatric populations to domestic violence. We therefore aimed to review studies on the prevalence of, and the evidence for the effectiveness of interventions in, psychiatric patients experiencing domestic violence.

Method

Literature search using Medline, PsycINFO and EMBASE applying the following inclusion criteria: English-language papers, data provided on the prevalence of or interventions for domestic violence, adults in contact with mental health services.

Results

Reported lifetime prevalence of severe domestic violence among psychiatric in-patients ranged from 30% to 60%. Lower rates are reported for men when prevalence is reported by gender. No controlled studies were identified. Low rates of detection of domestic violence occur in routine clinical practice and there is some evidence that, when routine enquiry is introduced into services, detection rates improve, but identification of domestic violence is rarely used in treatment planning. There is a lack of evidence on the effectiveness of routine enquiry in terms of morbidity and mortality, and there have been no studies investigating specific domestic violence interventions for psychiatric patients.

Conclusions

There is a high prevalence of domestic violence in psychiatric populations but the extent of the increased risk in psychiatric patients compared with other populations is not clear because of the limitations of the methodology used in the studies identified. There is also very limited evidence on how to address domestic violence with respect to the identification and provision of evidence-based interventions in mental health services.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2009

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