Consequences of Domestic Violence on Women’s Mental Health in Bosnia and Herzegovina
Reported, January 12, 2012
Methods
The study was carried out in the Tuzla Canton region in the period from 2000 to 2002, and included 283 women aged 43±9.6 years. Out of 283 women, 104 received psychiatric treatment at the Department for Psychiatry of the University Clinical Center Tuzla, 50 women were refugees; and 129 were domicile inhabitants of the Tuzla Canton. Domestic Violence Inventory, Cornell Index, Symptom Checklist-90-Revised, PTSD Checklist Version for Civilians, and Beck Depression Inventory were used for data collection. Basic sociodemographic data and information from the medical documentation of the Department for Psychiatry of the University Clinical Center Tuzla was also collected.
Results
Out of 283 women, 215 (75.9%) were physically, psychologically, and sexually abused by their husbands. Among the abused, 107 (50.7%) experienced a combination of various forms of domestic violence. The frequency of domestic violence was high among psychiatric patients (78.3%). Victims of domestic violence had a significantly higher rate of general neuroticism, depression, somatization, sensitivity, obsessive-compulsive symptoms, anxiety, and paranoid tendency than women who were not abused. The prevalence of posttraumatic stress disorder (PTSD) symptoms according to the type of trauma was higher in women with the history of childhood abuse (8/11) and domestic violence (53/67) than in women who experienced war trauma (26/57) and the loss of loved ones (24/83). The majority of 104 psychiatric patients suffered from PTSD in comorbidity with depression (n=45), followed by depression (n=17), dissociative disorder (n=13), psychotic disorder (n=7), and borderline personality disorder with depression (n=7). The intensity of psychological symptoms, depression, and Global Severity Index for Psychological Symptoms (GSI) were in significant positive correlation with the frequency of psychological (r=0.45, P<0.001), physical (r=0.43, P<0.001), and sexual abuse (r=0.37, P<0.001).
Conclusion
Domestic violence in various forms had long-term consequences on mental health of women. This should be taken into account when treating women with war-related trauma.
Domestic violence and its consequences for the physical and psychological well-being of women and children have been recognized as an important public health problem . However, despite the fact that domestic violence has been the focus of research since the 1970s, information about the prevalence of this problem is still scarce in many countries, especially in the developing world. Current studies indicate that 20%-50% of women worldwide have experienced some form of domestic violence in their lifetime . Consequences of domestic violence, characterized by women’s experience of physical, psychological, and sexual injury or threat are manifold. A significant number of studies consider domestic violence as risk factor for health problems, including injury and death , consequences on pregnancy and newborns , and on women’s mental health . Psychological problems associated with domestic violence have been well documented among women who asked for professional help. Among the most frequently reported psychological consequences are depression , high suicide risk , loss of trust, low self-esteem, fear, anxiety, guilt, shame, tension, suspicion, somatic problems, and posttraumatic stress disorder (PTSD) .
Domestic violence has been recognized as a problem in Bosnia and Herzegovina for the first time after the end of war in 1995. International Helsinki Federation for Human Rights Report, based on a small number of reported cases from the year 2004, estimated that 25 percent of women were victims of domestic violence . Currently, there are no epidemiological studies about the exposure of women to various types of violence. In addition, violence against women, including domestic violence, is still not discussed in public. It is estimated that domestic violence is present in one out of four families in Bosnia and Herzegovina .
Our aim was to assess mental health consequences and symptoms of PTSD in women victims of domestic violence who lived in Bosnia and Herzegovina. We analyzed the frequency and types of domestic violence experienced by women either currently or at any time in their lives from current or former intimate partner or boyfriend. Additionally, this study examined the prevalence of domestic violence in women who received psychiatric treatment.
We used the term domestic violence to refer to a range of sexually, psychologically, and physically coercive acts used against adult and adolescent women by current or former male intimate partners.
In conclusion, the results from our study indicate that domestic violence is a serious public health problem in Bosnia and Herzegovina, with deep and lasting consequences on the mental health of women. Significant number of women suffered from anxiety, depression, and PTSD, which were often comorbid. The findings of this study may be used as recommendations for establishing health protocols with an aim of early detection of victims of domestic violence and the prevention of its consequences.
Credits:Esmina Avdibegovic and Osman Sinanovic
Department of Psychiatry and Neurology, University Clinical Center Tuzla, Tuzla University School of Medicine, Tuzla, Bosnia and Herzegovina
More information at:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080462/