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      A cross-sectional analysis of women’s mental health problems: examining the association with different types of violence among a sample of Brazilian mothers

      research-article
      1 , , 1 , 2
      BMC Women's Health
      BioMed Central
      Women, Violence, Mental health

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          Abstract

          Background

          Mental health problems are the major cause of disability in poor countries, and women are the individuals most affected. The World Health Organization points out that violence against women is the leading cause of mental health problems. This study seeks to identify explanatory factors for women’s mental health problems, highlighting situations of violence suffered by them during childhood, when living with a partner and in the community.

          Method

          A cross-sectional analysis was conducted with 389 mothers with schoolchildren in a city in the state of Rio de Janeiro (Brazil). Profile variables and childhood and adult life experiences were researched and organized in three analytical blocks. A binary logistic regression model was used, divided into hierarchical blocks.

          Results

          The final model shows that women who were the victims of severe physical violence by their partner were more likely (OR = 8.2) to suffer from mental health problems than those who had never been exposed to this type of violence. The mothers of children with behavior problems are more likely to have mental health problems (OR = 3.0) than mothers whose children do not manifest behavioral problems.

          Conclusion

          This study shows that women’s mental health problems are particularly related to the experience of physical violence, especially that occurring in intimate partner relationships. Based on this premise, this work recommends that multidimensional issues need to be included in women’s health assistance programs duly incorporating the specificity of victimization by violence.

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          Most cited references24

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          Health consequences of intimate partner violence.

          Intimate partner violence, which describes physical or sexual assault, or both, of a spouse or sexual intimate, is a common health-care issue. In this article, I have reviewed research on the mental and physical health sequelae of such violence. Increased health problems such as injury, chronic pain, gastrointestinal, and gynaecological signs including sexually-transmitted diseases, depression, and post-traumatic stress disorder are well documented by controlled research in abused women in various settings. Intimate partner violence has been noted in 3-13% of pregnancies in many studies from around the world, and is associated with detrimental outcomes to mothers and infants. I recommend increased assessment and interventions for intimate partner violence in health-care settings.
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            Poverty and common mental disorders in developing countries.

            A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries. Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experience of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders. The direct and indirect costs of mental ill-health worsen the economic condition, setting up a vicious cycle of poverty and mental disorder. Common mental disorders need to be placed alongside other diseases associated with poverty by policy-makers and donors. Programmes such as investment in education and provision of microcredit may have unanticipated benefits in reducing the risk of mental disorders. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment.
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              Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries.

              1624 patients who were attending primary health facilities in 4 developing countries were examined to determine how many were suffering from mental disorder. Using stringent criteria to establish the presence of psychiatric morbidity, 225 cases were found, indicating an overall frequency of 13.9%. The great majority of cases were suffering from neurotic illnesses and for most the presenting complaint was of a physical symptom, such as headache, abdominal pain, cough or weakness. The health workers following their normal procedure correctly detected one third of the psychiatric cases.
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                Author and article information

                Journal
                BMC Womens Health
                BMC Womens Health
                BMC Women's Health
                BioMed Central
                1472-6874
                2013
                15 April 2013
                : 13
                : 20
                Affiliations
                [1 ]Latin-American Center of Studies of Violence and Health Jorge Careli (National School of Public Health)/Oswaldo Cruz Foundation, Avenida Brasil 4036 sala 700, Manguinhos, Rio de Janeiro, Brazil
                [2 ]Institute of Clinical Research Evandro Chagas/Oswaldo Cruz Foundation, Avenida Brasil 4036, Manguinhos, Rio de Janeiro, Brazil
                Article
                1472-6874-13-20
                10.1186/1472-6874-13-20
                3637256
                23587110
                72065e8d-d76c-442d-9e29-380bf17db6e2
                Copyright ©2013 Avanci et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 June 2012
                : 2 April 2013
                Categories
                Research Article

                Obstetrics & Gynecology
                women,violence,mental health
                Obstetrics & Gynecology
                women, violence, mental health

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