Academic journal article Indian Journal of Psychological Medicine

Experience of Domestic Violence and Psychological Morbidity in Spouses of Alcohol-Dependent Males

Academic journal article Indian Journal of Psychological Medicine

Experience of Domestic Violence and Psychological Morbidity in Spouses of Alcohol-Dependent Males

Article excerpt

Byline: Pankajakshan. Indu, Chandran. Jinu, Noorudheen. Pallikkal, Ramya. Sampathkumar, Jomon. Joy

Background: Prevalence of both domestic violence (DV) and alcohol use is reported to be high in Kerala. The prevalence of DV and psychological morbidity in spouses of alcohol-dependent males has not been studied objectively. Methods: This cross-sectional study was undertaken to study the occurrence of DV and psychological morbidity-major depressive disorder (MDD), anxiety disorders, and adjustment disorders-in spouses of alcohol-dependent males attending the de-addiction center of a tertiary care hospital in South India. Sixty consecutive cases, aged 18-55 years, were recruited after getting informed consent. They were assessed using Domestic Violence Questionnaire (DVQ), Mini International Neuropsychiatric Interview Schedule, and a questionnaire to assess adjustment disorder. The association of DV with psychological morbidities was also studied. Results: DV was reported by 41 (68.3%, 95% confidence interval [CI] = 55.0-79.7) cases. At least one psychiatric morbidity was observed in 51 (85.0%, 95% CI = 72.9-92.5) cases-MDD in 15 (25.0%, 95% CI = 15.1-38.1), anxiety disorders in 6 (10%, 95% CI = 4.1-21.2), and adjustment disorder in 32 (53.3%, 95% CI = 40.1-66.1) cases each. No statistically significant association was observed between DV and any of the psychiatric disorders. However, DVQ scores showed significant correlation with years of marriage (Pearson's r = 0.268, P < 0.05) and with stressful life events over the past 1 year (Pearson's r = 0.424, P < 0.05). Conclusions: High rates of DV and psychological morbidity were seen in spouses of alcohol-dependent males.

Introduction

Violence against women is a major human rights abuse and an important public health concern. The World Health Organization (WHO) Multi-country Study on Women's Health and Domestic Violence found the lifetime prevalence of physical and/or sexual partner violence among ever-partnered women in 15 countries to range from 15% to 71% and it was found to be 4%-54% in the past year.[1] A multisite household survey conducted in India found that about 26% of women reported physical violence in the past 12 months.[2] In this study, among urban nonslum sites, the highest prevalence rates for physical and psychological violence (43.1% and 61.6%, respectively) were reported from Thiruvananthapuram, Kerala.[2] Various studies have found that partner alcohol abuse was associated with an increased risk of intimate partner violence (IPV) in women.[3],[4],[5] A study conducted in Pune, India, had assessed IPV using a 4-item questionnaire which assessed physical and emotional abuse, but not sexual violence.[5]

Spousal domestic violence (DV) against women is reported to have far-reaching mental health implications in the victims. Depression, posttraumatic stress disorder (PTSD), anxiety, self-harm, and sleep disorders are well documented to be mental health sequelae of IPV.[6],[7] The Study of Abuse in the Family Environment (India-SAFE) reported that alcohol consumption by husband and exposure to physical violence were significantly associated with an increased risk of poor mental health in women. Psychological morbidity was not evaluated objectively, but assessed using a self-reported questionnaire in this study.[8] A study done in Palakkad, Kerala, found that DV was reported by almost two-thirds of spouses of alcohol-dependent males attending a tertiary care center, but the questionnaire used to assess DV was not validated in the local language. On clinical evaluation, two-thirds of these spouses had clinical depression and 11% had suicidal thoughts.[9] In another study, sixty spouses of men with alcohol dependence (AD) were assessed using a structured clinical interview schedule. They found that 65% of the participants had a psychiatric disorder; mood and anxiety disorders were the most common problems reported.[10] A population-based survey done in northern part of Goa assessed women aged 18-49 years using General Health Questionnaire and reported that excessive partner alcohol use led to a two- to three-fold increase in risk for common mental disorders. …

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