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BMC Psychiatry
Published in: BMC Psychiatry 1/2014

Open Access 01-12-2014 | Research article

Intimate partner violence and its contribution to mental disorders in men and women in the post genocide Rwanda: findings from a population based study

Authors: Aline Umubyeyi, Ingrid Mogren, Joseph Ntaganira, Gunilla Krantz

Published in: BMC Psychiatry | Issue 1/2014

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Abstract

Background

In low income countries, mental disorders are a neglected health problem. Mental disorders are influenced by a number of factors in people's everyday life of which intimate partner violence (IPV) commonly form an important part. The aim of this study was to investigate the prevalence of mental disorders in young men and women in Rwanda and their risk factors with main emphasis on IPV and its contribution to mental disorders, taking into account the genocide context.

Methods

This population-based study included a representative sample of 917 men and women aged 20-35 years. The prevalence of mental disorders was investigated using of a diagnostic tool, the "MINI: Mini International Neuropsychiatric Interview". Risk factor patterns were analysed with bi- and multivariate logistic regression. To find the proportion of mental disorders attributed to IPV, the population attributable fraction was computed.

Results

The prevalence rates of current depression, suicide risk and PTSD were more than two times higher in women than in men while for generalized anxiety disorder, the prevalence was about the same. Physical, sexual and psychological intimate partner violence exposure was highly associated with all forms of mental disorders for women. For physical violence, after adjusting for socio-demographic factors and exposure to traumatic episodes during the Rwandan genocide, the risk of current depression for women was elevated four times. Even though few men reported partner violence exposure, physical violence in the past year was found to be a statistically significant risk factor for current depression and for generalized anxiety disorder. However, having an experience of traumatic episodes during the genocide contributed to the risk of most of mental disorders investigated for men.

Conclusion

In Rwanda, IPV contributed considerably to mental disorders investigated. Thus, prevention of IPV should be considered as a public health priority, as its prevention would considerably reduce the prevalence of mental disorders.
Literature
1.
2.
Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A: No health without mental health. Lancet 2007, 370(9590):859-877.
3.
McBain R, Norton DJ, Morris J, Yasamy MT, Betancourt TS: The role of health systems factors in facilitating access to psychotropic medicines: a cross-sectional analysis of the WHO-AIMS in 63 low- and middle-income countries. PLoS Med. 2012, 9 (1): e1001166-10.1371/journal.pmed.1001166.CrossRefPubMedPubMedCentral
4.
5.
Dillon G, Hussain R, Loxton D, Rahman S: Mental and Physical Health and Intimate Partner Violence against Women: A Review of the Literature. Int J Family Med. 2013, 2013: 313909-10.1155/2013/313909.CrossRefPubMedPubMedCentral
6.
Vos T, Astbury J, Piers LS, Magnus A, Heenan M, Stanley L, Walker L, Webster K: Measuring the impact of intimate partner violence on the health of women in Victoria, Australia. Bull World Health Organ. 2006, 84 (9): 739-744. 10.2471/BLT.06.030411.CrossRefPubMedPubMedCentral
7.
Ali TS, Mogren I, Krantz G: Intimate Partner Violence and Mental Health Effects: A Population-Based Study among Married Women in Karachi, Pakistan. Int J Behav Med. 2013, 20 (1): 131-139. 10.1007/s12529-011-9201-6.CrossRefPubMed
8.
Mahenge B, Likindikoki S, Stockl H, Mbwambo J: Intimate partner violence during pregnancy and associated mental health symptoms among pregnant women in Tanzania: a cross-sectional study. BJOG. 2013, 120 (8): 940-946. 10.1111/1471-0528.12185.CrossRefPubMed
9.
Deyessa N, Berhane Y, Alem A, Ellsberg M, Emmelin M, Hogberg U, Kullgren G: Intimate partner violence and depression among women in rural Ethiopia: a cross-sectional study. Clin Pract Epidemiol Ment Health. 2009, 5: 8-10.1186/1745-0179-5-8.CrossRefPubMedPubMedCentral
10.
Vung ND, Ostergren PO, Krantz G: Intimate partner violence against women, health effects and health care seeking in rural Vietnam. Eur J Public Health. 2009, 19 (2): 178-182. 10.1093/eurpub/ckn136.CrossRefPubMed
11.
12.
Lopez AD, Project DCP: Global burden of disease and risk factors. 2006, Oxford University Press, New York, NYCrossRef
13.
14.
Mathers C, Boerma T, Fat DM: World Health Organization. 2008, The Global Burden of Disease, 2004 Update, Geneva
15.
Verduin F, Engelhard EA, Rutayisire T, Stronks K, Scholte WF: Intimate Partner Violence in Rwanda: The Mental Health of Victims and Perpetrators. J Interpers Violence. 2012, 28 (9): 1839-1858. 10.1177/0886260512469106. doi:10.1177/0886260512469106CrossRefPubMed
16.
Umubyeyi A, Mogren I, Ntaganira J, Krantz G: Women are considerably more exposed to intimate partner violence than men in Rwanda: results from a population-based, cross-sectional study. BMC Womens Health. 2014, 14: 99-10.1186/1472-6874-14-99.CrossRefPubMedPubMedCentral
17.
Munyandamutsa N, Mahoro Nkubamugisha P, Gex-Fabry M, Eytan A: Mental and physical health in Rwanda 14 years after the genocide. Soc Psychiatry Psychiatr Epidemiol. 2012, 47 (11): 1753-1761. 10.1007/s00127-012-0494-9.CrossRefPubMed
18.
Schaal S, Weierstall R, Dusingizemungu JP, Elbert T: Mental health 15 years after the killings in Rwanda: imprisoned perpetrators of the genocide against the Tutsi versus a community sample of survivors. J Trauma Stress. 2012, 25 (4): 446-453. 10.1002/jts.21728.CrossRefPubMed
19.
Rieder H, Elbert T: Rwanda - lasting imprints of a genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners and their children. Confl Health. 2013, 7 (1): 6-10.1186/1752-1505-7-6.CrossRefPubMedPubMedCentral
20.
Ntaganira J, Muula AS, Masaisa F, Dusabeyezu F, Siziya S, Rudatsikira E: Intimate partner violence among pregnant women in Rwanda. BMC Womens Health. 2008, 8: 17-10.1186/1472-6874-8-17.CrossRefPubMedPubMedCentral
21.
Bolton P, Neugebauer R, Ndogoni L: Prevalence of depression in rural Rwanda based on symptom and functional criteria. J Nerv Ment Dis. 2002, 190 (9): 631-637. 10.1097/00005053-200209000-00009.CrossRefPubMed
22.
Lecrubier Y, Sheehan D, Weiller E, Amorim P, Bonora I, Sheehan K, Janavs J, Dunbar G: The M.I.N.I. International Neuropsychiatric Interview (M.I.N.I.) A Short Diagnostic Structured Interview: Reliability and Validity According to the CIDI. Eur Psychiatr. 1997, 12: 224-231. 10.1016/S0924-9338(97)83296-8.CrossRef
23.
24.
Abramsky T, Watts CH, Garcia-Moreno C, Devries K, Kiss L, Ellsberg M, Jansen HA, Heise L: What factors are associated with recent intimate partner violence? findings from the WHO multi-country study on women's health and domestic violence. BMC Publ Health. 2011, 11: 109-10.1186/1471-2458-11-109.CrossRef
25.
Neugebauer R, Fisher PW, Turner JB, Yamabe S, Sarsfield JA, Stehling-Ariza T: Post-traumatic stress reactions among Rwandan children and adolescents in the early aftermath of genocide. Int J Epidemiol. 2009, 38 (4): 1033-1045. 10.1093/ije/dyn375.CrossRefPubMed
26.
de Fouchier C, Blanchet A, Hopkins W, Bui E, Ait-Aoudia M, Jehel L: Validation of a French adaptation of the Harvard Trauma Questionnaire among torture survivors from sub-Saharan African countries. Eur J Psychotraumatol. 2012, 3:10.3402/ejpt.v3i0.19225. doi:10.3402/ejpt.v3i0.19225. Epub 2012 Dec 6
27.
Rugema L, Mogren I, Ntaganira J, Gunilla K: Traumatic episodes experienced during the genocide period in Rwanda influence life circumstances in young men and women 17 years later. BMC Public Health. 2013, 13: 1235-10.1186/1471-2458-13-1235.CrossRefPubMedPubMedCentral
28.
Oteng-Ntim E, Kopeika J, Seed P, Wandiembe S, Doyle P: Impact of Obesity on Pregnancy Outcome in Different Ethnic Groups: Calculating Population Attributable Fractions. PloS One. 2013, 8 (1): e53749-10.1371/journal.pone.0053749. doi:10.1371/journal.pone.0053749. Epub 2013 Jan 14CrossRefPubMedPubMedCentral
29.
30.
Ellsberg M, Heise L, Pena R, Agurto S, Winkvist A: Researching domestic violence against women: methodological and ethical considerations. Stud Fam Plann. 2001, 32 (1): 1-16. 10.1111/j.1728-4465.2001.00001.x.CrossRefPubMed
31.
Bonomi AE, Anderson ML, Rivara FP, Thompson RS: Health outcomes in women with physical and sexual intimate partner violence exposure. J Womens Health (2002). 2007, 16 (7): 987-997. 10.1089/jwh.2006.0239.CrossRef
32.
Vinck P, Pham PN: Association of exposure to intimate-partner physical violence and potentially traumatic war-related events with mental health in Liberia. Soc Sci Med (1982). 2013, 77: 41-49. 10.1016/j.socscimed.2012.10.026.CrossRef
33.
Pham PN, Weinstein HM, Longman T: Trauma and PTSD symptoms in Rwanda: implications for attitudes toward justice and reconciliation. JAMA. 2004, 292 (5): 602-612. 10.1001/jama.292.5.602.CrossRefPubMed
34.
Vinck P, Pham PN, Stover E, Weinstein HM: Exposure to war crimes and implications for peace building in northern Uganda. JAMA. 2007, 298 (5): 543-554. 10.1001/jama.298.5.543.CrossRefPubMed
35.
Sipsma H, Ofori-Atta A, Canavan M, Osei-Akoto I, Udry C, Bradley EH: Poor mental health in Ghana: who is at risk?. BMC Public Health. 2013, 13: 288-10.1186/1471-2458-13-288.CrossRefPubMedPubMedCentral
36.
Peltzer K, Pengpid S, McFarlane J, Banyini M: Mental health consequences of intimate partner violence in Vhembe district, South Africa. General Hospital Psychiatry. 2013, 35 (5): 545-550. 10.1016/j.genhosppsych.2013.04.001.CrossRefPubMed
37.
Vizcarra B, Hassan F, Hunter WM, Munoz SR, Ramiro L, De Paula CS: Partner violence as a risk factor for mental health among women from communities in the Philippines, Egypt, Chile, and India. Int J Inj Contr Saf Promot. 2004, 11 (2): 125-129. 10.1080/15660970412331292351.CrossRef
38.
Campbell JC: Health consequences of intimate partner violence. Lancet. 2002, 359 (9314): 1331-1336. 10.1016/S0140-6736(02)08336-8.CrossRefPubMed
39.
Resnick HS, Acierno R, Kilpatrick DG: Health impact of interpersonal violence. 2: Medical and mental health outcomes. Behav Med (Washington, DC). 1997, 23 (2): 65-78. 10.1080/08964289709596730.CrossRef
40.
Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C: Intimate partner violence and women's physical and mental health in the WHO multi-country study on women's health and domestic violence: an observational study. Lancet. 2008, 371 (9619): 1165-1172. 10.1016/S0140-6736(08)60522-X.CrossRefPubMed
41.
Foshee VA, Benefield TS, Ennett ST, Bauman KE, Suchindran C: Longitudinal predictors of serious physical and sexual dating violence victimization during adolescence. Prev Med. 2004, 39 (5): 1007-1016. 10.1016/j.ypmed.2004.04.014.CrossRefPubMed
42.
Devries KM, Mak JY, Bacchus LJ, Child JC, Falder G, Petzold M, Astbury J, Watts CH: Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med. 2013, 10 (5): e1001439-10.1371/journal.pmed.1001439.CrossRefPubMedPubMedCentral
43.
Jonsson U, Bohman H, Hjern A, von Knorring L, Paaren A, Olsson G, von Knorring AL: Intimate relationships and childbearing after adolescent depression: a population-based 15 year follow-up study. Soc Psychiatry Psychiatr Epidemiol. 2011, 46 (8): 711-721. 10.1007/s00127-010-0238-7.CrossRefPubMed
44.
Reid RJ, Bonomi AE, Rivara FP, Anderson ML, Fishman PA, Carrell DS, Thompson RS: Intimate partner violence among men prevalence, chronicity, and health effects. Am J Prev Med. 2008, 34 (6): 478-485. 10.1016/j.amepre.2008.01.029.CrossRefPubMed
45.
Pronyk PM, Hargreaves JR, Kim JC, Morison LA, Phetla G, Watts C, Busza J, Porter JD: Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. Lancet. 2006, 368 (9551): 1973-1983. 10.1016/S0140-6736(06)69744-4.CrossRefPubMed
Metadata
Title
Intimate partner violence and its contribution to mental disorders in men and women in the post genocide Rwanda: findings from a population based study
Authors
Aline Umubyeyi
Ingrid Mogren
Joseph Ntaganira
Gunilla Krantz
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2014
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-014-0315-7

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