Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Primary Care
Published in: BMC Primary Care 1/2010

Open Access 01-12-2010 | Research article

The association between intimate partner violence, alcohol and depression in family practice

Authors: Gail Gilchrist, Kelsey Hegarty, Patty Chondros, Helen Herrman, Jane Gunn

Published in: BMC Primary Care | Issue 1/2010

Login to get access

Abstract

Background

Depressive symptoms, intimate partner violence and hazardous drinking are common among patients attending general practice. Despite the high prevalence of these three problems; the relationship between them remains relatively unexplored.

Methods

This paper explores the association between depressive symptoms, ever being afraid of a partner and hazardous drinking using cross-sectional screening data from 7667 randomly selected patients from a large primary care cohort study of 30 metropolitan and rural general practices in Victoria, Australia. The screening postal survey included the Center for Epidemiological Studies Depression Scale, the Fast Alcohol Screening Test and a screening question from the Composite Abuse Scale on ever being afraid of any intimate partner.

Results

23.9% met criteria for depressive symptoms. A higher proportion of females than males (20.8% vs. 7.6%) reported ever being afraid of a partner during their lifetime (OR 3.2, 95%CI 2.5 to 4.0) and a lower proportion of females (12%) than males (25%) were hazardous drinkers (OR 0.4; 95%CI 0.4 to 0.5); and a higher proportion of females than males (20.8% vs. 7.6%) reported ever being afraid of a partner during their lifetime (OR 3.2, 95%CI 2.5 to 4.0). Men and women who had ever been afraid of a partner or who were hazardous drinkers had on average higher depressive symptom scores than those who had never been afraid or who were not hazardous drinkers. There was a stronger association between depressive symptoms and ever been afraid of a partner compared to hazardous drinking for both males (ever afraid of partner; Diff 6.87; 95% CI 5.42, 8.33; p < 0.001 vs. hazardous drinking in last year; Diff 1.07, 95% CI 0.21, 1.94; p = 0.015) and females (ever afraid of partner; Diff 5.26; 95% CI 4.55, 5.97; p < 0.001 vs. hazardous drinking in last year; Diff 2.23, 95% CI 1.35, 3.11; p < 0.001), even after adjusting for age group, income, employment status, marital status, living alone and education level.

Conclusions

Strategies to assist primary care doctors to recognise and manage intimate partner violence and hazardous drinking in patients with depression may lead to better outcomes from management of depression in primary care.
Literature
1.
2.
Fiellin DA, Reid MC, O'Connor PG: Screening for Alcohol Problems in Primary Care. A Systematic Review. Arch Intern Med. 2000, 160: 1977-1989. 10.1001/archinte.160.13.1977.CrossRefPubMed
3.
Hegarty K, Gunn J, Chondros P, Small R: Association between depression and abuse by partners of women attending general practice: descriptive, cross sectional survey. BMJ. 2004, 328: 621-624. 10.1136/bmj.328.7440.621.CrossRefPubMedPubMedCentral
4.
Herrman H, Patrick DL, Diehr P, Martin ML, Fleck M, Simon GE, et al: Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status, health service use and treatment of people with depressive symptoms. Psychol Med. 2002, 32: 889-902. 10.1017/S003329170200586X.CrossRefPubMed
5.
Britt H, Miller GC, Charles J, Henderson J, Bayram C, Harrison C, et al: General practice activity in Australia 2007-08. 2008, Canberra: Australian Institute of Health and Welfare, AIHW Catalogue No. GEP 22
6.
Mazza D, Dennerstein L, Ryan V: Physical, sexual and emotional violence against women: a general practice-based prevalence study. Med J Aust. 1996, 164: 14-17.PubMed
7.
Ehrensaft MK, Moffitt TE, Caspi A: Is Domestic Violence Followed by an Increased Risk of Psychiatric Disorders Among Women But Not Among Men? A Longitudinal Cohort Study. Am J Psychiat. 2006, 163: 885-92. 10.1176/appi.ajp.163.5.885.CrossRefPubMed
8.
Wingood GM, DiClemente RJ, Raj A: Adverse consequences of intimate partner abuse among women in non-urban domestic violence shelters. Am J Prev Med. 2000, 119: 183-192.
9.
Golding JM: Intimate partner violence as a risk factor for mental disorders: a meta-analysis. J Fam Viol. 1999, 14: 99-132. 10.1023/A:1022079418229.CrossRef
10.
Campbell JC: Health consequences of intimate partner violence. Lancet. 2002, 359: 1331-6. 10.1016/S0140-6736(02)08336-8.CrossRefPubMed
11.
McCambridge J, Platts S, Whooley D, Strang J: Encouraging GP alcohol intervention: pilot study of change-orientated reflective listening (CORL). Alc Alcoholism. 2004, 39: 146-149. 10.1093/alcalc/agh027.CrossRef
12.
Taft A, Broom DH, Legge D: General practitioner management of intimate partner abuse and the whole family: qualitative study. BMJ. 2004, 28: 618-621. 10.1136/bmj.38014.627535.0B.CrossRef
13.
Proude EM, Britt H, Valenti L, Conigrave KM: The relationship between self-reported alcohol intake and the morbidities managed by GPs in Australia. BMC Fam Pract. 2006, 7: 17-10.1186/1471-2296-7-17.CrossRefPubMedPubMedCentral
14.
Proude EM, Conigrave KM, Haber PS: Effectiveness of skills-based training using the Drink-less package to increase family practitioner confidence in intervening for alcohol use disorders. BMC Med Educ. 2006, 6: 8-10.1186/1472-6920-6-8.CrossRefPubMedPubMedCentral
15.
Miller D, Jaye C: GPs' perception of their role in the identification and management of family violence. Fam Pract. 2007, 24: 95-101. 10.1093/fampra/cmm001.CrossRefPubMed
16.
Kraemer KL: The cost-effectiveness and cost-benefit of screening and brief intervention for unhealthy alcohol use in medical settings. Subst Abuse. 2007, 28: 67-77. 10.1300/J465v28n03_07.CrossRef
17.
Babor TF, McRee BG, Kassebaum PA, Grimaldi PL, Ahmed K, Bray J: Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse. Subst Abuse. 2007, 28: 7-30. 10.1300/J465v28n03_03.CrossRef
18.
Bertholet MD, Daeppen J, Wietlisbach V, Fleming M, Burnand B: Reduction of alcohol consumption by brief alcohol intervention in primary care systematic review and meta-analysis. Arch Intern Med. 2005, 165: 986-995. 10.1001/archinte.165.9.986.CrossRefPubMed
19.
Feder G, Ramsay J, Dunne D, Rose M, Arsene C, Norman R, et al: How Far Does Screening Women for Domestic (Partner) Violence in Different Health-care Settings Meet Criteria for a Screening Programme? Systematic reviews of nine UK National Screening Committee criteria. Health Technology Assessment. 2009, 13: 6-CrossRef
20.
Hegarty K, Bush R: Prevalence of partner abuse in women attending Australian General Practice: A cross-sectional survey. Aust N Z J Public Health. 2002, 26: 437-442. 10.1111/j.1467-842X.2002.tb00344.x.CrossRefPubMed
21.
Sohal H, Eldridge S, Feder G: The sensitivity and specificity of four questions (HARK) to identify intimate partner violence: a diagnostic accuracy study in general practice. BMC Fam Pract. 2007, 8: 49-10.1186/1471-2296-8-49.CrossRefPubMedPubMedCentral
22.
Sullivan LE, Fiellin DA, O'Connor PG: The prevalence and impact of alcohol problems in major depression: a systematic review. Am J Med. 2005, 118: 330-341. 10.1016/j.amjmed.2005.01.007.CrossRefPubMed
23.
Arch JJ, Craske MG, Stein MB, Sherbourne CD, Roy-Byrne PP: Correlates of alcohol use among anxious and depressed primary care patients. Gen Hosp Psychiat. 2006, 28: 37-42. 10.1016/j.genhosppsych.2005.08.007.CrossRef
24.
Roeloffs CA, Fink A, Unützer J, Tang L, Wells KB: Problematic Substance Use, Depressive Symptoms, and Gender in Primary Care. Psychiatr Serv. 2001, 52: 1251-1253. 10.1176/appi.ps.52.9.1251.CrossRefPubMed
25.
Teesson M, Hall W, Lynskey M, Degenhardt L: Alcohol and drug-use disorders in Australia: Implications of the National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry. 2000, 34: 206-213.CrossRefPubMed
26.
Astbury J, Atkinson J, Duke JE, Easteal PL, Kurrle SE, Tait PR, et al: The impact of domestic violence on individuals. Med J Aust. 2000, 173: 427-431.PubMed
27.
Brienza RS, Stein MD: Alcohol use disorders in primary care: do gender-specific differences exist?. J Gen Intern Med. 2002, 17: 387-397.PubMedPubMedCentral
28.
Ulrich YC, Cain KC, Sugg NK, Rivara FP, Rubanowice DM, Thompson RS: Medical care utilization patterns in women with diagnosed domestic violence. Am J Prev Med. 2003, 24: 9-15. 10.1016/S0749-3797(02)00577-9.CrossRefPubMed
29.
Proudfoot H, Teesson M: The association of alcohol dependence with general practice attendance. Drug Alcohol Rev. 2009, 28: 154-159. 10.1111/j.1465-3362.2008.00019.x.CrossRefPubMed
30.
Access Economics: The cost of domestic violence to the Australian economy: Part 1. Canberra. 2005, --- Either first page or author must be supplied..
31.
Gerber MR, Ganz ML, Lichter E, Williams CM, McCloskey LA: Adverse health behaviors and the detection of partner violence by clinicians. Arch Intern Med. 2005, 165: 1016-1021. 10.1001/archinte.165.9.1016.CrossRefPubMed
32.
Kilpatrick DG, Acierno R, Resnick HS, Saunders BE, Best CL: A 2-year longitudinal analysis of the relationships between violent assault and substance use in women. J Consult Clin Psychol. 1997, 65: 834-847. 10.1037/0022-006X.65.5.834.CrossRefPubMed
33.
Krug EG, Mercy JA, Dahlberg LL, Zwi AB: The world report on violence and health. Lancet. 2002, 360: 1083-1088. 10.1016/S0140-6736(02)11133-0.CrossRefPubMed
34.
Rehn N, Room R, Edwards G: Alcohol in the European Region - Consumption, Harm, and Policies. 2001, Copenhagen: World Health Organization Regional Office for Europe
35.
Gunn JM, Gilchrist GP, Chondros P, Ramp M, Hegarty KL, Blashki GA, et al: Who is identified when screening for depression is undertaken in general practice? Baseline findings from the Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) longitudinal study. Med J Austr. 2008, 188: S119-S25.
36.
Wathen CN, Tanaka M, Catallo C, Lebner AC, Friedman MK, Hanson MD, et al: Are clinicians being prepared to care for abused women? A survey of health professional education in Ontario, Canada. BMC Med Educ. 2009, 9: 34-CrossRefPubMedPubMedCentral
37.
Feder G, Ramsay J, Dunne D, Rose M, Arsene C, Norman R, et al: How far does screening women for domestic (partner) violence in different health-care settings meet the UK National Screening Committee criteria for a screening programme in terms of condition, screening method and intervention? Systematic reviews of nine UK National Screening Committee criteria. Health Technology Assessment. 2009, 13: 16-CrossRef
38.
Potiriadis M, Chondros P, Gilchrist G, Hegarty K, Blashki G, Gunn J: How do Australian patients rate their general practitioner? A descriptive study using the General Practice Assessment Questionnaire. Med J Austr. 2008, 189: 215-219.
39.
Radloff LS: The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977, 1: 385-401. 10.1177/014662167700100306.CrossRef
40.
Hodgson R, Alwyn T, Brown J, Thom B, Smith A: The FAST Alcohol Screening Test. Alc Alcoholism. 2002, 37: 61-66. 10.1093/alcalc/37.1.61.CrossRef
41.
Hodgson RJ, John B, Abbasi T, Hodgson RC, Waller S, Thom B, et al: Fast screening for alcohol misuse. Addict Behav. 2003, 28: 1453-1463. 10.1016/S0306-4603(02)00246-0.CrossRefPubMed
42.
Babor TF, de la Fuente JR, Saunders J, Grant M: AUDIT. The Alcohol Use Disorders Identification Test. Guidelines for use in primary health care. Geneva. 1992
43.
Hegarty K, Sheehan M, Sconfeld C: A Multidimensional Definition of Partner Abuse: Development and Preliminary Validation of the Composite Abuse Scale. J Fam Viol. 1999, 14: 399-415. 10.1023/A:1022834215681.CrossRef
44.
Hegarty K, Bush R, Sheahan M: The Composite Abuse Scale: Further development and assessment of reliability in two clinical settings. Viol Vict. 2005, 20: 529-547. 10.1891/vivi.2005.20.5.529.CrossRef
45.
Ware J, Kosinski M, Keller SD: A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996, 34: 220-233. 10.1097/00005650-199603000-00003.CrossRefPubMed
46.
StataCorp: Stata Statistical Software. 2007, Texas: College Station, StataCorp LP, Release 10
47.
Britt HC, Harrison CM, Miller GC, Knox SA: Prevalence and patterns of multimorbidity in Australia. Med J Aust. 2008, 189: 72-77.PubMed
48.
Ramsay J, Richardson J, Carter YH, Davidson LL, Feder G: Should health professionals screen women for domestic violence? Systematic review. BMJ. 2002, 325: 314-10.1136/bmj.325.7359.314.CrossRefPubMedPubMedCentral
49.
Duxbury F: Recognising domestic violence in clinical practice using the diagnoses of posttraumatic stress disorder, depression and low self-esteem. Br J Gen Pract. 2006, 56: 294-300.PubMedPubMedCentral
50.
51.
Kaner EFS, Beyer F, Dickinson HO, Pienaar E, Campbell F, Schlesinger C, et al: Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2007, 18 (2): CD004148-
52.
Hegarty K, O'Doherty L, Gunn J, Pierce D, Taft A: A brief counseling intervention by health professionals utilising the 'readiness to change' concept for women experiencing intimate partner abuse: The weave project. J Fam Stud. 2008, 14: 376-388. 10.5172/jfs.327.14.2-3.376.CrossRef
53.
MacMillan HL, Wathen CN, Jamieson E, et al: Screening for intimate partner violence in health care settings: a randomized trial. JAMA. 2009, 302: 493-501. 10.1001/jama.2009.1089.CrossRefPubMed
54.
Hegarty K, Taft A, Feder G: Working with the whole family when domestic violence is present: what do generalists need to know?. BMJ. 2008, 337: 346-351. 10.1136/bmj.a839.CrossRef
Metadata
Title
The association between intimate partner violence, alcohol and depression in family practice
Authors
Gail Gilchrist
Kelsey Hegarty
Patty Chondros
Helen Herrman
Jane Gunn
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2010
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-11-72

Other articles of this Issue 1/2010

BMC Primary Care 1/2010 Go to the issue

Research article

U.S. healthcare providers' knowledge, attitudes, beliefs, and perceptions concerning Chronic Fatigue Syndrome

Research article

Recognizing and managing anxiety disorders in primary health care in Turkey

Research article

The prevalence and correlates of depression and anxiety in a sample of diabetic patients in Sharjah, United Arab Emirates

Research article

Nurses joining family doctors in primary care practices: perceptions of patients with multimorbidity

Research article

Low hospital admission rates for respiratory diseases in children

Commentary

Urinary tract infections in healthy women: a revolution in management?