Intimate Partner Violence Survivors More Likely to Develop Chronic Illness

Women exposed to intimate partner violence (IPV) have a greater risk of developing fibromyalgia or chronic fatigue syndrome (CFS), according to a new report.

According to the National Coalition Against Domestic Violence, one in every four women and one in every nine men in the United States experience severe intimate partner physical violence; close to 20 people experience abuse every minute.

Study author professor Siddhartha Bandyopadhyay, of the University of Birmingham’s Business School’s Department of Economics and Centre for Crime, Justice and Policing, said in a press release, “We have been aware that domestic abuse has significant negative effects for victims and their children. This and other related work by our team showing strong associations with several diseases suggests that the costs of abuse are even greater than understood previously.

“The higher incidence of long-term illnesses, such as chronic fatigue syndrome, for abused women implies the existence of an additional hidden cost to society that we need to understand better.”

The researchers conducted a retrospective cohort study, which was published in the Journal of Interpersonal Violence, using data from The Health Improvement Network database spanning Jan. 1, 1995, through Dec. 1, 2017. Women exposed to IPV (n = 18,547) were age-matched to four controls not exposed to IPV (n = 74,188). The primary outcome measures were the risk of developing fibromyalgia and CFS, which the authors calculated as adjusted incidence rate ratios (aIRRs).

A total of 97 women in the IPV group developed fibromyalgia (incidence rate [IR]=1.63 per 1,000 person-years) versus 239 in the control group (IR=0.83 per 1,000 person-years); the calculated aIRR was 1.73 (95% CI, 1.36-2.2). CFS presented in 19 women in the IPV group (IR=0.32 per 1,000 person-years), versus 53 in the control group (0.18 per 1,000 person-years), translating to an aIRR of 1.92 (95% CI, 1.11-3.33).

“Domestic abuse is a global public health issue, with as many as one in three women affected world-wide,” said fellow study author Dr. Joht Singh Chandan, adding, “Considering the prevalence of domestic abuse, and the fact that patients experiencing fibromyalgia and CFS often face delays in diagnosis due to a limited understanding generally of how these conditions are caused, it is important for clinicians to bear in mind that women who have survived abuse are at a greater risk of these conditions.

“We hope these first of their kind research findings will change healthcare practice and will be of assistance in the early diagnosis of fibromyalgia and CFS in women who have been abused.”

Study author professor Julie Taylor, of the University of Birmingham’s School of Nursing, said that “more research needs to be done to establish the biopsychosocial pathways that cause this link between abuse and these types of health conditions.

“This is a very complex relationship and it is important to [emphasize] that not all women who have been abused will develop fibromyalgia or CFS, and that having these conditions does not mean there has been domestic abuse in the past.”