Consequences of domestic violence on women's mental health in Bosnia and Herzegovina.
OBJECTIVE
To assess psychological consequences of domestic violence, and determine the frequency and forms of domestic violence against women in Bosnia and Herzegovina.


METHODS
The study was carried out in the Tuzla Canton region in the period from 2000 to 2002, and included 283 women aged 43+/-9.6 years. Out of 283 women, 104 received psychiatric treatment at the Department for Psychiatry of the University Clinical Center Tuzla, 50 women were refugees; and 129 were domicile inhabitants of the Tuzla Canton. Domestic Violence Inventory, Cornell Index, Symptom Checklist-90-Revised, PTSD Checklist Version for Civilians, and Beck Depression Inventory were used for data collection. Basic sociodemographic data and information from the medical documentation of the Department for Psychiatry of the University Clinical Center Tuzla was also collected.


RESULTS
Out of 283 women, 215 (75.9%) were physically, psychologically, and sexually abused by their husbands. Among the abused, 107 (50.7%) experienced a combination of various forms of domestic violence. The frequency of domestic violence was high among psychiatric patients (78.3%). Victims of domestic violence had a significantly higher rate of general neuroticism, depression, somatization, sensitivity, obsessive-compulsive symptoms, anxiety, and paranoid tendency than women who were not abused. The prevalence of posttraumatic stress disorder (PTSD) symptoms according to the type of trauma was higher in women with the history of childhood abuse (8/11) and domestic violence (53/67) than in women who experienced war trauma (26/57) and the loss of loved ones (24/83). The majority of 104 psychiatric patients suffered from PTSD in comorbidity with depression (n=45), followed by depression (n=17), dissociative disorder (n=13), psychotic disorder (n=7), and borderline personality disorder with depression (n=7). The intensity of psychological symptoms, depression, and Global Severity Index for Psychological Symptoms (GSI) were in significant positive correlation with the frequency of psychological (r=0.45, P<0.001), physical (r=0.43, P<0.001), and sexual abuse (r=0.37, P<0.001).


CONCLUSIONS
Domestic violence in various forms had long-term consequences on mental health of women. This should be taken into account when treating women with war-related trauma.
Avdibegović
Esmina
E
Department of Psychiatry and Neurology, University Clinical Center Tuzla, Tuzla University School of Medicine, Tuzla, Bosnia and Herzegovina. esmina@bih.net.ba
Sinanović
Osman
O
D000293:Adolescent; D000328:Adult; D018585:Battered Women / Q000523:psychology*; D017522:Bosnia and Herzegovina; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000523:psychology*