Intimate partner violence and depression in rural Bangladesh

Accounting for violence severity in a high prevalence setting

Precious Esie, Theresa L Osypuk, Sidney R. Schuler, Lisa M. Bates

Research output: Contribution to journalArticle

Abstract

Intimate partner violence (IPV) against women is highly prevalent globally, and is associated with adverse health outcomes, including depression. Though women living in low- and middle-income countries (LMICs) face a larger burden of IPV, little is known about whether IPV increases the risk of depression among non-pregnant women and in contexts of high prevalence. Within the setting of rural Bangladesh, this study examined the relationship between the severity of marital IPV against women and the risk of depression. Data were drawn from a nationally-representative study focused on individual and contextual determinants of IPV among married women aged 16–37 years in rural Bangladesh, collected through a multistage, stratified sample in 77 villages in 2014 (n=3290). Multivariable log-binomial regression models were used to estimate the association between the severity of IPV (operationalized as the frequency of different acts of psychological, physical, and sexual abuse, as well as injury due to IPV) and risk of major depressive episode (MDE) using the Edinburgh Postnatal Depression Scale (EPDS). One in six women (16.8%) met the criteria for MDE. Past year IPV was endemic; psychological (77.2%) was most common, followed by sexual (58.8%) and physical (44.4%). Nearly a third of women experienced IPV-related injury. There was a positive dose-response relationship between severity of each type of IPV and MDE above the lowest level of exposure. In adjusted models, the highest levels of psychological (RR=2.27, 95% CI: 1.62, 3.17), physical (RR=2.44, 95% CI: 1.94, 3.08), and sexual (RR=1.65, 95% CI: 1.08, 2.52) IPV severity remained significantly associated with MDE, as well as experiencing IPV-related injury (RR=1.72, 95% CI: 1.23, 2.40). In rural Bangladesh, the severity of all types of marital IPV against women is strongly related to increased risk of MDE. Results suggest the limited utility of standard dichotomous IPV indicators in high prevalence settings.

Original languageEnglish (US)
Article number100368
JournalSSM - Population Health
Volume7
DOIs
StatePublished - Apr 1 2019

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Bangladesh
Violence
Depression
violence
Psychology
Intimate Partner Violence
Wounds and Injuries
Postpartum Depression
Sex Offenses
Statistical Models
sexual violence
wife

Keywords

  • Bangladesh
  • Depression
  • Intimate partner violence
  • Violence severity

Cite this

Intimate partner violence and depression in rural Bangladesh : Accounting for violence severity in a high prevalence setting. / Esie, Precious; Osypuk, Theresa L; Schuler, Sidney R.; Bates, Lisa M.

In: SSM - Population Health, Vol. 7, 100368, 01.04.2019.

Research output: Contribution to journalArticle

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abstract = "Intimate partner violence (IPV) against women is highly prevalent globally, and is associated with adverse health outcomes, including depression. Though women living in low- and middle-income countries (LMICs) face a larger burden of IPV, little is known about whether IPV increases the risk of depression among non-pregnant women and in contexts of high prevalence. Within the setting of rural Bangladesh, this study examined the relationship between the severity of marital IPV against women and the risk of depression. Data were drawn from a nationally-representative study focused on individual and contextual determinants of IPV among married women aged 16–37 years in rural Bangladesh, collected through a multistage, stratified sample in 77 villages in 2014 (n=3290). Multivariable log-binomial regression models were used to estimate the association between the severity of IPV (operationalized as the frequency of different acts of psychological, physical, and sexual abuse, as well as injury due to IPV) and risk of major depressive episode (MDE) using the Edinburgh Postnatal Depression Scale (EPDS). One in six women (16.8{\%}) met the criteria for MDE. Past year IPV was endemic; psychological (77.2{\%}) was most common, followed by sexual (58.8{\%}) and physical (44.4{\%}). Nearly a third of women experienced IPV-related injury. There was a positive dose-response relationship between severity of each type of IPV and MDE above the lowest level of exposure. In adjusted models, the highest levels of psychological (RR=2.27, 95{\%} CI: 1.62, 3.17), physical (RR=2.44, 95{\%} CI: 1.94, 3.08), and sexual (RR=1.65, 95{\%} CI: 1.08, 2.52) IPV severity remained significantly associated with MDE, as well as experiencing IPV-related injury (RR=1.72, 95{\%} CI: 1.23, 2.40). In rural Bangladesh, the severity of all types of marital IPV against women is strongly related to increased risk of MDE. Results suggest the limited utility of standard dichotomous IPV indicators in high prevalence settings.",
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