Physical intimate partner violence in Europe: results from a population-based multi-center study in six countries

INTRODUCTION: The prevalence, determinants and health consequences of physical intimate partner violence (IPV) in Western Europe has never been considered in a cross-cultural perspective, taking men and women involvement in the three patterns of violence: victims, perpetrators or both. METHODS: We assessed a representative sample of adults (18-64 years; N=3496) living in Athens-Greece, Porto-Portugal, Budapest-Hungary, London-United Kingdom, Östersund-Sweden and Stuttgart-Germany. Past-year physical IPV was assessed using the Revised-Conflict-Tactics-Scales. The association between IPV and child abuse, socioeconomics (education, occupation, unemployment duration), behavioral (alcohol) and health factors (chronic diseases, anxiety and depressive symptoms), by sex and IPV pattern, was estimated using age- and city-adjusted logistic regression odds ratios (AOR, 95% confidence intervals). RESULTS: Physical IPV was reported by 17.7% (16.0-19.4%) of women (3.5% victims-only, 4.2% perpetrators-only and 10.0% both victims and perpetrators) and by 19.8% (17.8-22.0%) of men (4.1%, 3.8% and 11.9%, respectively). In general, Greek presented the highest and Portuguese the lowest estimates. History of child abuse increased the risk of all IPV patterns. In women, unemployment duration and blue collar occupation were associated with increased likelihood of all IPV patterns. In men, only unemployment duration was associated with increased perpetration and lower occupation with victimization. Heavy alcohol use, chronic diseases and self-assessment of health as poor or fair were significantly associated with female involvement in IPV, both as victim and perpetrator. Anxiety and depressive symptoms severity was higher in male and female declaring both victimization and perpetration. CONCLUSIONS: In these European men and women IPV was frequently experienced and child abuse a common determinant of victimization, perpetration or bi-directional violence. Irrespective of IPV pattern, socioeconomic inequalities were evident in females but less consistent in males. These findings confirm IPV as a major public health concern, and for those involved it significantly increases the burden of disease

Forgone healthcare and intimate partner violence: A study in six European urban centres

Costa D, Hatzidimitriadou E, Ioannidi-Kapolou E, et al. Forgone healthcare and intimate partner violence: A study in six European urban centres. Presented at the 142nd American Public Health Association Annual Meeting and Exposition, New Orleans

Intimate partner violence and health-related quality of life in European men and women: findings from the DOVE study

Little is known on the specific relation between being a perpetrator or both a victim and perpetrator of intimate partner violence (IPV) and health-related quality of life (HRQoL). We assessed the association between HRQoL and abuse, considering men and women as victims, perpetrators or reciprocally. Participants were adult men and women (n = 3,496), randomly selected from the general population of six European cities. The Revised-Conflict-Tactics-Scales and the Medical-Outcomes-Study 36-item Short-Form Health Survey (SF-36) were used to measure IPV and HRQoL. The age-, education-, and city-adjusted mean scores[standard error] of the physical and of the mental SF-36 component summaries were used to compare victims-only, perpetrators-only, and those involved in both (bidirectional or reciprocal cases) with those not involved in past-year and lifetime physical assault and/or sexual coercion. The physical component summary was significantly lower in women involved in past-year bidirectional physical assault compared with non-abused women. The mental component summary in women not involved in IPV was significantly higher than in those physically abused, regardless of type of involvement. Women victims-only of past-year sexual coercion and victims or involved in bidirectional concomitant physical and sexual IPV also presented lower scores in the mental component summary than women not involved in IPV. In men, significantly lower scores in the mental component summary were found in the past-year bidirectional physically assaulted group and among those involved bidirectionally in both physical and sexual IPV compared with men not involved in IPV. Experiencing physical and sexual IPV is negatively associated with HRQoL. Lower scores in the mental component summary of the SF-36 are evident among female victims and among males and females involved in intimate partner violence as both victims and perpetrators when compared to females and males not involved in violence

The e-mental health treatment in Stockholm myocardial infarction with non-obstructive coronaries or Takotsubo syndrome study (E-SMINC) : a study protocol for a randomised controlled trial

Background: In the aftermath of a myocardial infarction with non-obstructive coronary arteries (MINOCA) or Takotsubo syndrome (TS), patients commonly express high levels of stress and anxiety. Current treatment alternatives rarely address these issues. Methods: The study is a randomised controlled trial, where 90 patients with a discharge diagnosis of MINOCA or TS who also report symptoms of stress or anxiety will be randomised 2-6 weeks after their cardiac event. The treatment consists of 10 weeks of Internet-based cognitive behaviour therapy (CBT) and starts immediately after randomisation for the treatment group. The control group receives usual care. Main outcomes are symptoms of anxiety measured with the Hospital Anxiety and Depression scale, anxiety subscale, and perceived stress measured with the Perceived Stress Scale, 14-item version, 10 weeks after randomisation. Secondary measures include cardiac specific anxiety, symptoms of post-traumatic stress, quality of life, cortisol measured in hair and physiological stress responses (heart rate variability, blood pressure and saliva cortisol) during a stress procedure. Ten weeks after randomisation, the control group will also receive treatment. Long-term followup in the self-report measures mentioned above will be conducted 20 and 50 weeks after randomisation where the total group's development over time is followed, and the groups receiving intervention early versus late compared. Discussion: At present, there are no randomised studies evaluating psychological treatment for patients with MINOCA or TS. There is an urgent need for treatment alternatives aiming at relieving stress and anxiety considering the high mental stress and anxiety levels observed in MINOCA and TS, leading to decreased quality of life. CBT aiming at reducing mental stress has been shown to be effective regarding prognosis in patients with coronary artery disease. The current protocol describes a randomised open-label controlled trial evaluating an Internet-based CBT program for reduction of stress and anxiety in patients with increased mental stress and/or anxiety with a discharge diagnosis of either MINOCA or TS

Effects of EMDR psychotherapy on 99mTc-HMPAO distribution in occupation-related post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a derangement of mood control with involuntary, emotionally fraught recollections that may follow deep psychological trauma in susceptible individuals. This condition is treated with pharmacological and/or cognitive therapies as well as psychotherapy with eye movement desensitization and reprocessing (EMDR). However, only a very limited number of studies have been published dealing with work-related PTSD, and investigations on the effect of treatment on cerebral blood flow represent an even smaller number

Intimate Partner Violence and Use of Primary and Emergency Care: The Role of Informal Social Support

Social support may encourage victims to disclose their experiences of intimate partner violence (IPV), but also to seek the appropriate help and care in the social and health services. Using data from a multicenter European project, DOVE (Domestic Violence Against women/men in Europe-prevalence, determinants, effects, and policies/practices), the present study aimed at measuring the frequency of primary care and emergency use according to IPV types of victimization, and to investigate whether victims receiving different levels of informal social support are using health care differently. Results suggested a significant association between IPV types and use of emergency services, and no association was found regarding primary care services. Victims of physical abuse and sexual coercion went to the emergency department (ED) more frequently (more than once a year). Also, victims of physical abuse receiving low social support visited an ED more frequently than those with high social support, whereas victims of sexual coercion with high informal social support went more often to the ED compared with victims of sexual coercion with low social support, even after controlling for other covariates. These results seem to suggest that social support has a significant role in the decision to use health care among victims of IPV

Alcohol use among abused and non-abused older persons aged 60-84 years: An European study

Aims: Describing alcohol use by abuse type (e.g. psychological) and considering other factors (e.g. depression). Methods: The respondents were 4467 (2559 women, 57.3%) randomly selected elders (60-84 years) from seven European cities. The cross-sectional data were collected with scales covering various areas and examined with bivariate/multivariate methods. Findings: Psychologically abused elders were more often alcohol users than non-users (21.7% vs. 16.3%) and the opposite regarding financially abused elders (4.8% vs. 3.5%). Psychologically abused elders also had more often three or more drinks containing alcohol in a drinking day (21.1% vs. 16.1%) and six or more drinks on one occasion (24.5% vs. 18.3%). Psychological abuse, demographics/socio-economics (e.g. education), smoking and leisure activities were positively associated alcohol use, and being from certain countries (e.g. Italy), age (e.g. 80-84 years), depression and financial abuse negatively. Conclusions: Across countries, 64.2% of the elders were drinkers. Some variables (e.g. psychological abuse) were positively related to alcohol use and others (e.g. depression) negatively. Many of the elders were exposed to abuse. Our findings may be useful to prevent/manage drinking and abuse among elders. However, alcohol use was influenced by various factors that need to be further elucidated, particularly the relation between abuse and drinking

Factors associated with refraining from buying prescribed medications among older people in Europe

AimTo evaluate the associations between refraining from buying prescribed medications and selected factors among older persons. MethodsA total of 4467 people aged 60-84 years from seven European countries answered a questionnaire (response rate 45.2%). Refraining from buying prescribed medications was measured with the question: Have you ever refrained from buying prescribed medication and care?’ ResultsAbout 11.9% of older people refrained from buying prescribed medications. The multiple regression analysis showed that ages 60-64 (odds ratio (OR) = 2.08; 95% confidence interval (95%CI): 1.38-3.13) and 65-69 (OR = 1.73; 95%CI: 1.16-2.57) years, experience of financial strain (OR = 1.59; 95%CI: 1.27-2.01), as well as exposure to abuse (OR = 1.64; 95%CI: 1.31-2.06) when taking into account country of participant were independently associated with refraining from buying medications, while an opposite association was observed for being male (OR = 0.72; 95%CI: 0.58-0.91). ConclusionsThe study found that refraining from buying prescription medications is a problem among older people and identified a number of factors associated with this

The relationship between abuse, psychosocial factors, and pain complaints among older persons in Europe

Background and objective: Abuse and pain complaints are common among older persons. However, little is known about relationships between abuse (e.g. psychological) and pain complaints (e.g. backache) among older persons while considering other factors (e.g. depression). Therefore, the aim of this study was to determine these relationships. Materials and methods: The design was cross-sectional. A total of 4467 women and men aged 60-84 years from Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden answered questionnaires regarding various areas such as abuse, mental health (e.g. anxiety) and pain complaints (e.g. backache). The data were examined with bivariate (analyses of variance) and multivariate methods (linear regressions). Results: The bivariate analyses showed that psychological abuse was connected with all pain complaints; physical with headache and head pressure; sexual with neck or shoulder pain and headache; injury with all complaints (except pain in joints or limbs); financial with pain in joints or limbs and head pressure; and overall abuse (one or more types) with all complaints (except headache). The regressions showed that psychological abuse increased the likelihood of being affected by head pressure and heaviness or tiredness in the legs; physical abuse of being affected by headache and head pressure; financial abuse of being affected by head pressure; and overall abuse of being affected by headache and head pressure. In general, respondents from Sweden and younger (60-64 years) were less affected by the complaints than those from other counties (e.g. Germany) and older (e.g. 70-74 years), respectively. Respondents on medication (e.g. pain killers) were less affected by all pain complaints and those with high social support by pain in joints or limbs. High scores on anxiety and depression and having many diseases increased the likelihood of being affect by all pain complaints. Conclusions: Abuse was related with certain pain complaints (e.g. headache), but other factors and in particular mental health and physical diseases impacted on all pain complaints. Medication and partly social support had a positive effect on the pain experience, i.e. the complaints interfered less with for instance the daily-life of the respondents. (C) 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved