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Violence and poor mental health and functional outcomes

BMJ 2011; 343 doi: (Published 17 November 2011) Cite this as: BMJ 2011;343:d7311
  1. Christina Nicolaidis, associate professor
  1. 1Departments of Medicine and Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR 97239, USA
  1. nicolaid{at}

Information about lifetime experience of violence may have important clinical implications

Two large scale, well conducted studies have recently been added to the substantial literature on the health correlates of violence against women and children. The first was a population based survey of 4451 Australian women, in which more than a quarter of participants disclosed at least one lifetime experience of gender based violence.1 Consistent with many other studies,2 3 it found a strong dose-response association between the number of forms of such violence and the odds of any of the mental health conditions assessed.

The finding is hardly surprising. Why wouldn’t experiencing violence be associated with poor mental health outcomes? But the strength of the associations is sobering. Even having experienced only one form of gender based violence doubled or tripled the odds of each of the mental health conditions assessed. And having experienced three to four types increased the odds for any lifetime mental disorder to 11, and the odds for attempted suicide to almost 15. The attributable risk is astoundingly high after putting together …

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