Intimate partner violence related to self-harm, male and female suicidality

Posted in The Lancet PsychiatryA new study is the first to show that intimate partner violence (IPV) is strongly associated with self-harm and suicidality in both men and women, and at all ages in England.

While IPV is a recognized risk factor for psychiatric disorders, there was previously little evidence on IPV, self-harm and suicidality.

Led by the Violence and Society Center of City, University of London, in collaboration with the University of Manchester, University of Leicester, University College London and University of Bristol, the study was an analysis of the results of the Adult Psychiatric Morbidity Survey (APMS) conducted face-to-face with over 7,000 adults, in 2014/5.

A nationally representative sample of households in England was interviewed, collecting information on gender, age, socio-economic status, ethnicity and regional location.

Study participants were asked about experiences of physical abuse and sexual, economic, and emotional abuse by a current or former partner, as well as suicidal thoughts, suicide attempts, and self-harm.

The study found that 27% of women and 15% of men had experienced domestic violence at some point in their lives, confirming that women are much more likely than men to be victims of violence by of a partner. People who experienced domestic violence were more likely to live in more deprived neighborhoods and also to have experienced many other adversities in their lives. However, the associations between spousal violence and self-harm and suicidality remained strong even when these other factors were adjusted for.

After adjusting for experience of other adversities, as well as demographic and socioeconomic factors, people who have ever experienced IPV in their lifetime, compared with those who have not, had during the previous year:

• more than twice the risk of self-harm without suicidal intent
• almost twice the risk of having suicidal thoughts
• and nearly three times the risk of attempted suicide

If IPV had been experienced within the previous year, the risks were even higher.

Particularly high rates of self-harm, suicidal thoughts, and suicide attempts have been found among people who have ever been subjected to sexual and emotional abuse, those who have ever suffered physical harm from domestic violence, and those who have experienced multiple forms of intimate partner violence, indicating that the more a person is exposed to many types of intimate partner violence, the higher the risk of self-harm and suicide.

There is a high likelihood that a person presenting to services in suicidal distress will be a victim of domestic violence (IPV). Health, social and welfare professionals need to ask people who have self-injured or are at risk of suicide if they are victims of IPV, and professionals need to be prepared – and supported – to act accordingly. »

Sally McManus, Senior Lecturer in Health at the Center for Violence and Society and School of Health Sciences, City, University of London and first author of the study

Dr Estela Barbosa, senior researcher at the Violence and Society Centre, City, University of London and co-author said:

“Intimate partner violence is common in England, particularly among women. The gender gap was widest for sexual IPV, which was about ten times more common among women than men, and this type of IPV was associated with particularly high risks of self-harm and suicidality.

Dr Duleeka Knipe, Population Health Sciences at Bristol Medical School, University of Bristol, Bristol and co-author said:

“Strategies for reducing violence should be part of suicide risk assessment and safety planning at the individual level, and they should be included in national suicide prevention strategies. Interventions designed to reduce the prevalence and duration of IPV could protect and improve the lives of people at risk of self-harm and suicide.”