title: Physical health consequences of physical and psychological intimate partner violence.
abstract: BACKGROUND
  Past studies that have addressed the health effects of intimate partner violence (IPV) have defined IPV as violence based on physical blows that frequently cause injuries. To our knowledge, no epidemiologic research has assessed the physical health consequences of psychological forms of IPV.
  
  
  OBJECTIVE
  To estimate IPV prevalence by type and associated physical health consequences among women seeking primary health care.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A total of 1152 women, aged 18 to 65 years, recruited from family practice clinics from February 1997 through January 1999 and screened for IPV during a brief in-clinic interview; health history and current status were assessed in a follow-up interview.
  
  
  RESULTS
  Of 1152 women surveyed, 53.6% ever experienced any type of partner violence; 13.6% experienced psychological IPV without physical IPV. Women experiencing psychological IPV were significantly more likely to report poor physical and mental health (adjusted relative risk [RR], 1.69 for physical health and 1.74 for mental health). Psychological IPV was associated with a number of adverse health outcomes, including a disability preventing work (adjusted RR, 1.49), arthritis (adjusted RR, 1.67), chronic pain (adjusted RR, 1.91), migraine (adjusted RR, 1.54) and other frequent headaches (adjusted RR, 1.41), stammering (adjusted RR, 2.31), sexually transmitted infections (adjusted RR, 1.82), chronic pelvic pain (adjusted RR, 1.62), stomach ulcers (adjusted RR, 1.72), spastic colon (adjusted RR, 3.62), and frequent indigestion, diarrhea, or constipation (adjusted RR, 1.30). Psychological IPV was as strongly associated with the majority of adverse health outcomes as was physical IPV.
  
  
  CONCLUSIONS
  Psychological IPV has significant physical health consequences. To reduce the range of health consequences associated with IPV, clinicians should screen for psychological forms of IPV as well as physical and sexual IPV.
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina, School of Public Health, Columbia 29208, USA. acoker@sph.sc.edu
authors.forename: A L
authors.initials: AL
authors.lastname: Coker
authors.forename: P H
authors.initials: PH
authors.lastname: Smith
authors.forename: L
authors.initials: L
authors.lastname: Bethea
authors.forename: M R
authors.initials: MR
authors.lastname: King
authors.forename: R E
authors.initials: RE
authors.lastname: McKeown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D017579:Domestic Violence; D005260:Female; D006801:Humans; D008875:Middle Aged