Mental disorders and intimate partner violence perpetrated by men towards women: a Swedish population-based longitudinal study
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BACKGROUND: Intimate partner violence (IPV) against women is associated with a wide range of adverse outcomes. Although mental disorders have been linked to an increased risk of perpetrating IPV against women, the direction and magnitude of the association remain uncertain. In a longitudinal design, we examined the association between mental disorders and IPV perpetrated by men towards women in a population-based sample and used sibling comparisons to control for factors shared by siblings, such as genetic and early family environmental factors. METHODS AND FINDINGS: Using Swedish nationwide registries, we identified men from 9 diagnostic groups over 1998-2013, with sample sizes ranging from 9,529 with autism to 88,182 with depressive disorder. We matched individuals by age and sex to general population controls (ranging from 186,017 to 1,719,318 controls), and calculated the hazard ratios of IPV against women. We also estimated the hazard ratios of IPV against women in unaffected full siblings (ranging from 4,818 to 37,885 individuals) compared with the population controls. Afterwards, we compared the hazard ratios for individuals with psychiatric diagnoses with those for siblings using the ratio of hazard ratios (RHR). In sensitivity analyses, we examined the contribution of previous IPV against women and common psychiatric comorbidities, substance use disorders and personality disorders. The average follow-up time across diagnoses ranged from 3.4 to 4.8 years. In comparison to general population controls, all psychiatric diagnoses studied except autism were associated with an increased risk of IPV against women in men, with hazard ratios ranging from 1.5 (95% CI 1.3-1.7) to 7.7 (7.2-8.3) (p-values < 0.001). In sibling analyses, we found that men with depressive disorder, anxiety disorder, alcohol use disorder, drug use disorder, attention deficit hyperactivity disorder, and personality disorders had a higher risk of IPV against women than their unaffected siblings, with RHR values ranging from 1.7 (1.3-2.1) to 4.4 (3.7-5.2) (p-values < 0.001). Sensitivity analyses showed higher risk of IPV against women in men when comorbid substance use disorders and personality disorders were present, compared to risk when these comorbidities were absent. In addition, increased IPV risk was also found in those without previous IPV against women. The absolute rates of IPV against women ranged from 0.1% to 2.1% across diagnoses over 3.4 to 4.8 years. Individuals with alcohol use disorders (1.7%, 1,406/82,731) and drug use disorders (2.1%, 1,216/57,901) had the highest rates. Our analyses were restricted to IPV leading to arrest, suggesting that the applicability of our results may be limited to more severe forms of IPV perpetration. CONCLUSIONS: Our results indicate that most of the studied mental disorders are associated with an increased risk of perpetrating IPV towards women, and that substance use disorders, as principal or comorbid diagnoses, have the highest absolute and relative risks. The findings support the development of IPV risk identification and prevention services among men with substance use disorders as an approach to reduce the prevalence of IPV.
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While there are a number of criticisms about the accuracy of disability weights it is doubtlessly true that depression is a highly burdensome condition and other studies have confirmed that the disability is experienced as one of the most severe of all health conditions.
“While there are a number of criticisms about the accuracy of disability weights 215-217 it is doubtlessly true that depression is a highly burdensome condition and other studies have confirmed that the disability is experienced as one of the most severe of all health conditions.”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [216]
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- Authors
- Yu, R., Nevado-Holgado, A. J., Molero, Y., D’Onofrio, B. M., Larsson, H., Howard, L. M., & Fazel, S.
- Affiliations
- University of Oxford (GB)
- Örebro University (SE)
- King's College London (GB)
- Corresponding author
- Fazel, Seena
- ORCID
- Venue
- PLOS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-12-17
- Volume
- 16
- Issue
- 12
- Pages
- e1002995
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC6917212
- OpenAlex
- W2995608653
- Cited by
- 152
- References
- 67
- Citations by year
- 2026: 16 · 2025: 20 · 2024: 26 · 2023: 27 · 2022: 24 · 2021: 25 · 2020: 14
- FWCI
- 15.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- Wellcome Trust (202836/Z/16/Z)
- Topics
- Social Sciences › Health › Intimate Partner and Family Violence
- Social Sciences › Sociology and Political Science › Stalking, Cyberstalking, and Harassment
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- intimate partner violence, mental illness, psychiatric comorbidity, substance use disorders, personality disorders, depressive disorders, anxiety disorders, alcoholism, drug use disorders, attention deficit hyperactivity disorder, autism spectrum disorder, sibling comparison, genetic and environmental factors, violence against women, Sweden, longitudinal cohort, registry study, risk factors for violence
- MeSH terms
- Intimate Partner Violence, Adolescent, Adult, Alcoholism, Mental Disorders, Female, Humans, Longitudinal Studies, Male, Middle Aged, Risk Factors, Sweden, Comorbidity, Prevalence, Substance-Related Disorders, Young Adult
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