Department of Natural and Applied Sciences, Bentley University, Waltham, Massachusetts.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
JAMA Netw Open. 2023 Mar 1;6(3):e232977. doi: 10.1001/jamanetworkopen.2023.2977.
During the COVID-19 pandemic, the prevalence and severity of intimate partner violence (IPV) increased. Associations between IPV and mental health symptoms and modifiable health factors early in the pandemic have yet to be explored.
To prospectively investigate the association of IPV with greater risk of mental health symptoms and adverse health factors during the COVID-19 pandemic in 3 cohorts of female participants.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used observational data from 3 prospective, population-based, longitudinal cohorts in the US: the Nurses' Health Study II, Growing Up Today Study, and Nurses' Health Study 3. Data analyzed included baseline and follow-up survey responses about IPV experiences early in the pandemic (March-September 2020); mental health domains of depression, anxiety, and posttraumatic stress symptoms (PTSS); and modifiable health factors (May 2020-October 2021). Female participants (both health care professionals and non-health care workers) aged 21 to 60 years from the 3 cohorts were included in the full analytic sample.
Experience of IPV measured by the Relationship Assessment Tool and fear of partner.
Mental health symptoms, including depression, anxiety, and PTSS, and modifiable health factors, including sleep duration, sleep quality, physical activity, alcohol use, and use of alcohol or other substances to cope with stress.
The full analytic sample included 13 597 female participants with a mean (SD) age of 44 (10.6) years. Accounting for sociodemographic factors and prepandemic mental health symptoms and correcting for multiple testing, experiencing IPV was associated with higher endorsement of depression (odds ratio [OR], 1.44; 95% CI, 1.38-1.50), anxiety (OR, 1.31; 95% CI, 1.26-1.36), and PTSS (OR, 1.22; 95% CI, 1.15-1.29) in random-effects meta-analyses across the 3 cohorts. The IPV experience was also associated with poorer sleep quality (OR, 1.21; 95% CI, 1.16-1.26), shorter sleep duration (OR, 1.13; 95% CI, 1.08-1.19), increased use of alcohol (OR, 1.10; 95% CI, 1.06-1.14), and use of alcohol or other substances to cope with stress (OR, 1.13; 95% CI, 1.08-1.18) across all cohorts as well as decreased physical activity (OR, 1.17; 95% CI, 1.09-1.26) in the Nurses' Health Study II only.
Results of the study showed that IPV experiences at the start of the pandemic were associated with worse mental health symptoms and modifiable health factors for female participants younger than 60 years. Screening and interventions for IPV and related health factors are needed to prevent severe, long-term health consequences.
在 COVID-19 大流行期间，亲密伴侣暴力 (IPV) 的发生率和严重程度有所增加。在大流行早期，IPV 与心理健康症状和可改变的健康因素之间的关联尚未得到探讨。
前瞻性研究 3 个女性参与者队列中 IPV 与大流行期间更大的心理健康症状和不良健康因素风险之间的关系。
设计、地点和参与者：本队列研究使用了来自美国 3 个前瞻性、基于人群、纵向队列的观察性数据：护士健康研究 II、今日成长研究和护士健康研究 3。分析的数据包括大流行早期（2020 年 3 月至 9 月）关于 IPV 经历的基线和随访调查答复；心理健康领域的抑郁、焦虑和创伤后应激症状 (PTSS)；以及可改变的健康因素（2020 年 5 月至 2021 年 10 月）。来自这 3 个队列的年龄在 21 至 60 岁之间的女性健康护理专业人员和非健康护理工作者参与者均纳入全分析样本。
使用关系评估工具和对伴侣的恐惧来衡量 IPV 经历。
心理健康症状，包括抑郁、焦虑和 PTSS，以及可改变的健康因素，包括睡眠持续时间、睡眠质量、身体活动、饮酒以及使用酒精或其他物质来应对压力。
全分析样本包括 13597 名女性参与者，平均（SD）年龄为 44（10.6）岁。考虑到社会人口统计学因素和大流行前的心理健康症状，并对多次测试进行了校正，在随机效应荟萃分析中，经历 IPV 与更高程度的抑郁（优势比 [OR]，1.44；95%置信区间 [CI]，1.38-1.50）、焦虑（OR，1.31；95% CI，1.26-1.36）和 PTSS（OR，1.22；95% CI，1.15-1.29）相关。在所有队列中，IPV 经历还与较差的睡眠质量（OR，1.21；95% CI，1.16-1.26）、较短的睡眠时间（OR，1.13；95% CI，1.08-1.19）、增加的饮酒量（OR，1.10；95% CI，1.06-1.14）以及使用酒精或其他物质来应对压力（OR，1.13；95% CI，1.08-1.18）相关，而仅在护士健康研究 II 中与身体活动减少（OR，1.17；95% CI，1.09-1.26）相关。
研究结果表明，大流行开始时的 IPV 经历与女性参与者 60 岁以下的心理健康症状和可改变的健康因素恶化有关。需要对 IPV 及相关健康因素进行筛查和干预，以预防严重的、长期的健康后果。
