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After violence, women's mental health suffers

By Amy Norton

NEW YORK (Reuters Health) - Women who have been sexually assaulted, abused by a partner or stalked may face high lifetime risks of depression and other mental health conditions, a new study suggests.

The study, of more than 4,400 Australian women, found that 27 percent said they had ever suffered any of four types of violence: rape, other types of sexual assault, physical abuse by a partner, or stalking.

And those women were three to 11 times more likely to have ever had a mental health condition like depression or anxiety disorders -- with the risk climbing in tandem with violent experiences.

Of women who'd suffered at least three of the four types of violence, a full 89 percent had had a mental health condition at some point in their lives, based on diagnostic interviews.

That compared with 28 percent of women who said they'd never experienced sexual assault, domestic abuse or stalking.

The findings, reported in the Journal of the American Medical Association, do not prove the violence, itself, caused women's mental health problems.

But it's likely, according to lead researcher Susan Rees, of the University of New South Wales in Sydney.

"There are compelling reasons to support the strong likelihood that gender-based violence is a major contributor to mental disorders in women," Rees told Reuters Health by email.

And in many cases, she noted, women in this study said their first experience with violence came at an early age, before the mental health problems.

"The strong association with mental disorders shown in this study indicates that violence against women should be considered and responded to as a major public health problem," Rees said.

Her team found that of the 139 women who'd suffered several different types of violence, 77 percent had an anxiety disorder at some point in their lives.

Meanwhile, more than half had had post-traumatic stress disorder or major depression, while nearly half had abused drugs or alcohol, and 35 percent said they'd attempted suicide.

When the researchers accounted for factors like education and income levels, these women were still 11 times more likely to have had some type of mental health problem, versus women who said they'd never been sexually assaulted, abused or stalked.

The risk was less pronounced, but still about three-fold greater, among women who'd been victims of one or two types of violence.

SEEK HELP RIGHT AWAY

Rees noted that the 27 percent rate of violence against women found in the Australian study was similar to that found in the U.S. - as were the links with poor mental health.

"There needs to be a full acknowledgement at all levels of society that gender-based violence remains at epidemic levels in our communities, and that the problem must be addressed through public campaigns to challenge social attitudes toward women and gender inequality," Rees said.

As for helping women, Rees said that mental health professionals generally need a better understanding of gender-based violence and how it affects women. And, she added, there needs to be more collaboration between the mental health field and services for abused women, so that more women get the help they need.

For women who've been victimized, Rees said the findings underscore the importance of seeking help right away.

"The reality is that once exposed, women are likely to experience the same form of abuse again or other forms of related abuse," Rees said. "The longer they delay in confronting the problem, the more likely they will incur the adverse consequences."

Of course, she added, getting out of a violent relationship can be easier said than done -- especially for women who rely on a partner financially -- and there need to be adequate community services set up to help.

Violence against women, Rees said, "is not an individual, but rather a social, problem."

SOURCE: http://bit.ly/nwRDdR Journal of the American Medical Association, August 3, 2011.

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