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Link between relationship violence and depression works both ways

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3088 (Published 15 May 2013) Cite this as: BMJ 2013;346:f3088

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Researchers trying to disentangle the complex association between physical abuse by an intimate partner and poor mental health analysed data from 16 longitudinal studies that measured both, mostly in women and girls. The association seemed to work both ways—violence by an intimate partner increased the odds of later depression (odds ratio 1.97, 95% CI 1.56 to 2.48) and symptoms of depression increased the odds of later violence (1.93, 1.51 to 2.48). In the limited number of studies that included men, they found an association between violence and later depression, not the reverse.

Together the studies looked at more than 36 000 participants, followed up for one to five years. Most studies considered only physical or sexual violence and looked for depressive symptoms rather than a diagnosis of major depression. Three studies reported a positive association between violence by an intimate partner and suicide attempts in women.

Although violence may cause symptoms of depression, and symptoms of depression may also predispose women to violence, it’s still possible that some as yet unidentified factor causes both, say the authors. Few of these studies adjusted their analyses for important confounders such as use of alcohol or childhood adversity, including sexual abuse.

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Cite this as: BMJ 2013;346:f3088