Ferrari Giulia, Agnew-Davies Roxane, Bailey Jayne, Howard Louise, Howarth Emma, Peters Tim J, Sardinha Lynnmarie, Feder Gene Solomon
Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK;
Domestic Violence Training Ltd, Surbiton, Surrey, UK.
Glob Health Action. 2016 Feb 8;9:29890. doi: 10.3402/gha.v9.29890. eCollection 2016.
Domestic violence and abuse (DVA) are associated with increased risk of mental illness, but we know little about the mental health of female DVA survivors seeking support from domestic violence services.
Our goal was to characterise the demography and mental health of women who access specialist DVA services in the United Kingdom and to investigate associations between severity of abuse and measures of mental health and health state utility, accounting for important confounders and moderators.
Baseline data on 260 women enrolled in a randomized controlled trial of a psychological intervention for DVA survivors were analysed. We report the prevalence of and associations between mental health status and severity of abuse at the time of recruitment. We used logistic and normal regression models for binary and continuous outcomes, respectively. The following mental health measures were used: Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), Patient Health Questionnaire, Generalised Anxiety Disorder Assessment, and the Posttraumatic Diagnostic Scale to measure posttraumatic stress disorder (PTSD). The Composite Abuse Scale (CAS) measured abuse.
Exposure to DVA was high, with a mean CAS score of 56 (SD 34). The mean CORE-OM score was 18 (SD 8) with 76% above the clinical threshold (95% confidence interval: 70-81%). Depression and anxiety levels were high, with means close to clinical thresholds, and more than three-quarters of respondents recorded PTSD scores above the clinical threshold. Symptoms of mental illness increased stepwise with increasing severity of DVA.
Women DVA survivors who seek support from DVA services have recently experienced high levels of abuse, depression, anxiety, and especially PTSD. Clinicians need to be aware that patients presenting with mental health conditions or symptoms of depression or anxiety may be experiencing or have experienced DVA. The high psychological morbidity in this population means that trauma-informed psychological support is needed for survivors who seek support from DVA services.
家庭暴力和虐待（DVA）与精神疾病风险增加相关，但对于向家庭暴力服务机构寻求帮助的女性DVA幸存者的心理健康状况，我们知之甚少。
我们的目标是描述在英国使用专业DVA服务的女性的人口统计学特征和心理健康状况，并调查虐待严重程度与心理健康及健康状态效用指标之间的关联，同时考虑重要的混杂因素和调节因素。
对260名参与针对DVA幸存者的心理干预随机对照试验的女性的基线数据进行了分析。我们报告了招募时心理健康状况与虐待严重程度之间的患病率及关联。我们分别对二元和连续结果使用了逻辑回归和正态回归模型。使用了以下心理健康测量指标：常规评估临床结果-结果测量量表（CORE-OM）、患者健康问卷、广泛性焦虑障碍评估量表以及用于测量创伤后应激障碍（PTSD）的创伤后诊断量表。使用综合虐待量表（CAS）测量虐待情况。
遭受DVA的情况很普遍，CAS平均得分为56（标准差34）。CORE-OM平均得分为18（标准差8），76%高于临床阈值（95%置信区间：70-81%）。抑郁和焦虑水平较高，均值接近临床阈值，超过四分之三的受访者PTSD得分高于临床阈值。随着DVA严重程度的增加，精神疾病症状呈逐步上升趋势。
向DVA服务机构寻求帮助的女性DVA幸存者近期遭受了高水平的虐待、抑郁、焦虑，尤其是PTSD。临床医生需要意识到，出现心理健康问题或抑郁或焦虑症状的患者可能正在经历或曾经经历过DVA。这一人群中心理疾病的高发病率意味着，对于向DVA服务机构寻求帮助的幸存者，需要提供创伤知情的心理支持。
