Physical abuse among depressed women.

OBJECTIVE

To provide estimates of physical abuse and use of health services among depressed women in order to inform efforts to increase detection and treatment of physical abuse.

DESIGN

Retrospective assessment of abuse and health services use over 1 year in a cohort of depressed women.

SETTING

Statewide community sample from Arkansas.

PARTICIPANTS

We recruited 303 depressed women through random-digit-dial screening.

MEASUREMENTS AND MAIN RESULTS

Exposure to physical abuse based on the Conflict Tactics Scale, multi-informant estimate of health and mental health services. Over half of the depressed women (55.2%) reported experiencing physical abuse as adults, with 14.5% reporting abuse during the study year. Women abused as adults had significantly more severe depressive symptoms, more psychiatric comorbidity, and more physical illnesses than nonabused women. After controlling for sociodemographic and severity-of-illness factors, recently abused, depressed women were much less likely to receive outpatient care for mental health problems as compared to other depressed women (odds ratio [OR] 0.3; p = .013), though they were more likely to receive health care for physical problems (OR 5.7, p = .021).

CONCLUSIONS

Because nearly all depressed women experiencing abuse sought general medical rather than mental health care during the year of the study, primary care screening for physical abuse appears to be a critical link to professional help for abused, depressed women. Research is needed to inform primary care guidelines about methods for detecting abuse in depressed women.