Violence and Quality of Life in Reproductive Age Women with Mental Disorder referred to Razi Educational Mental Health Service, 2014-2015.

Abstract

Abstract: Introduction: Women with mental disorders are more vulnerable to abuse, and domestic violence is associated with the onset and recurrence of mental disorders. There are few studies on domestic violence against patients with mental disorders, especially in developing countries and we found no study in Iran. Therefore, in this study we aimed to determine the status of domestic violence and quality of life in women of reproductive age with mental disorder referred to Razi educational mental health service of Tabriz, 4102-4102. Material and methods: In this cross-sectional study, 211 women with mental disorders controlled by drug, aged 09-29 years were interviewed using the Women Abuse Screening Tool (WAST), Revised Conflict Tactics Scale (CTS-4), WHO Quality of life-Bref (WHOQOL-BREF) and a socio-demographic questionnaires at a psychiatric hospital in Tabriz-Iran. Data were analyzed using Pearson correlation test, Independent t-test, One way ANOVA, Chi-square test, General Linear Model, Multivariate logistic regression model, Receiver operating characteristic (ROC) and Kappa. Result: The most and least common type of victimization and perpetration were negotiation-cognitive (victimization 90.49 and perpetration 92.59) and severe sexual coercion (victimization %2.49 and perpetration 5.59), respectively. The highest median (P42-P52) frequency of victimization and perpetration was in negotiation-cognitive domain [victimization %1 (04-24) and perpetration 21 (05- 52)] and the lowest was in severe Injury [victimization 2 (4-42) and perpetration2 (0-40)] and less sever sexual [2 (4-02)]. From the WHOQOL-BREF -011, environmental health domain had the highest mean score [24.5 (SD 05.%)] and psychological health domain had the lowest mean score [24.51 (SD 41.5)]. There were moderate significant positive correlations between chronicity of negotiation and all domains of WHOQOL-BREF (r=1.0% to 1.4%) and significant negative correlations between almost all domains of WHOQOL-BREF and domestic violence sub-scales. The highest diagnostic accuracy of WAST was in cut-off score of 04 (AUC 59.99, 929CI 54.49 to 95.29). The sensitivity of the optimal score was 92.99 (9%.29 to 95.29) and specificity 5%.99 (25.29 to 94.99). Predictive values were 95.29 (92.59 to 99.29) for victims and 2%.29 (25.09 to 52.29) for non-victims. Its agreement with CTS4 was good (r=1.29). The correlation of overall 5-item WAST score with CTS-4 was good (r=1.29) and both WAST-SF and WAST%-5 with CTS-4 was moderate (r= 1.25 and r=1.24, respectively). WAST-SF had a good correlation with overall 5-item WAST score (r=1.25) and strong correlation with WAST %-5 (r=1.50). Conclusion: Based on the results, prevalence of domestic violence among reproductive age women with mental disorders was high and there were significant correlations between domestic violence sub-scales and quality of life domains of life. As the WAST at cutoff score of 04 have good accuracy in diagnosis of intimate partner violence among the women, routine use of WAST for screening could improve detection of violence and therefore may improve psychiatric services.