Secondary analysis of a population-based, randomized controlled trial indicated intimate partner violence was statistically significantly associated with depression symptom severity in pregnant South African women.
“In a recently published systematic review, Devries and colleagues identified 13 longitudinal studies linking IPV to incident depression, none of which were conducted in sub-Saharan Africa. This is an important gap in the literature because rates of partner and nonpartner violence in sub-Saharan Africa are among the highest in the world,” Alexander C. Tsai, MD, PhD, of Massachusetts General Hospital, Boston, and colleagues wrote.
Alexander C. Tsai
To address literature gaps, researchers reanalyzed population-based, longitudinal data for 1,238 pregnant women who participated in a 3-year cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 months, 18 months and 36 months. Depression symptom severity was assessed via the Xhosa version of the 10-item Edinburgh Postnatal Depression scale.
Cross-sectional multivariable regression model analysis indicated a statistically significant association between lagged IPV intensity and depression symptom severity, when adjusting for potentially confounding time-fixed and time-varying covariates.
Quantile regression results indicated IPV had an estimated 4- to 5-fold greater impact on depression severity in the upper quintiles of conditional depression distribution.
A one-standard-deviation increase in IPV intensity was associated with an estimated 13% relative increase in depression mood.
Analysis also indicated a statistically significant association between lagged IPV intensity and probable depression. A one-standard-deviation increase in IPV intensity was associated with a 4 percentage-point increase in probable depression.
“Our findings are consistent with what has been shown in longitudinal studies conducted among women in high income countries, plausible in light of what is generally known about the adverse psychological impacts of stressful life events and traumatic stressors, and robust to alternative specifications and potential confounding by time-invariant factors,” the researchers wrote. “Taken together, our findings have important policy and programmatic implications for women’s health in sub-Saharan Africa.” – by Amanda Oldt
Disclosure: Tsai reports being a consulting editor for PLoS Medicine and an academic editor for PLoS ONE. Please see the full study for a list of all authors’ relevant financial disclosures.