The British Journal of Psychiatry (2013)

202, 9499. doi: 10.1192/bjp.bp.112.109934

Review article

Prevalence of experiences of domestic violence

among psychiatric patients: systematic review
S. Oram,* K. Trevillion,* G. Feder and L. M. Howard

Background
Domestic violence has been linked with many mental
disorders, including anxiety, depression, post-traumatic stress
disorder, eating disorders and psychosis.
Aims
To estimate the prevalence (adult lifetime and past year) of
different types of domestic violence experienced by men and
women receiving psychiatric treatment.
Method
In a systematic review, a search of 18 electronic databases
was supplemented by hand searching, citation tracking and
updating a recent systematic review of criminal victimisation
in psychiatric populations. Two reviewers independently
extracted data and appraised study quality.
Results
Forty-two studies were included. The median prevalence of
lifetime partner violence reported in high-quality papers
was 30% (interquartile range (IQR) 2639) among female
in-patients and 33% (IQR 2153) among female out-patients.
Among male patients, one high-quality study reported a
lifetime prevalence of 32% across mixed psychiatric settings.
No study included a control group.
Conclusions
Psychiatric patients experience a high prevalence of
domestic violence but there is limited information on family
(non-partner) domestic violence, the prevalence of emotional
abuse and the extent of risk compared with non-psychiatric
controls.
Declaration of interest
G.F. and L.M.H. are members of the World Health
Organization Guideline Development Group on Policy and
Practice Guidelines for Responding to Violence Against
Women and the National Institute for Health and Clinical
Excellence/Social Care Institute for Excellence Guideline
Development Group on Preventing and Reducing Domestic
Violence.

Domestic violence is a major public health issue and has been

Method
linked with many mental health problems including anxiety,
depression, post-traumatic stress disorder, eating disorders and Selection criteria
psychosis.15 Prospective studies have shown that psychiatric
Studies were eligible for inclusion if they included male or female
disorder can increase vulnerability to domestic violence, and that
psychiatric patients who were 16 years or older; presented the
domestic violence is associated with both risk and chronicity of
results of peer-reviewed research based on experimental studies
mental disorder.6,7 A systematic review of domestic violence
(e.g. randomised controlled trials, non-randomised controlled
prevalence studies noted that when comparing the mean lifetime
trials, parallel group studies), before and after studies, interrupted
prevalence across various healthcare settings, studies conducted
time series studies, cohort studies, casecontrol studies or cross-
in psychiatric clinics and obstetrics and gynaecology clinics
sectional studies; and measured the prevalence or risk of adult
recorded the highest prevalence of physical violence (3050%)
lifetime and/or past year domestic violence, or collected data
and sexual violence (3035%), whereas the highest mean lifetime
from which these statistics could be calculated. Mental health
prevalence of psychological violence was reported by studies
services were defined as secondary or tertiary care specialist
conducted in psychiatric clinics and emergency departments
services (in-patient, out-patient or community-based) providing
(6587%).8 Other reviews have also suggested a high prevalence
psychiatric care and support to people with mental disorders.
of being a victim of domestic violence among psychiatric
Domestic violence was defined as any incident of threatening
patients.9,10 Howard et al, for example, reported that the lifetime
behaviour, violence or abuse (psychological, physical, sexual,
prevalence of severe domestic violence ranged from 30% to 60%
financial or emotional) between adults who are or have been
among people receiving psychiatric in-patient treatment.10
intimate partners or family members regardless of gender or
However, these reviews did not critically appraise the quality of
sexuality.13 When the review identified multiple eligible papers
primary research. Moreover, previous reviews have largely
from the same study only the main paper reporting the largest
neglected mens experiences of domestic violence, despite evidence
number of participants with data of relevance to the objectives
of increased risk of victimisation among men with severe mental
of the review was included.
illness,11,12 and have given only limited consideration to broader
research on the violent victimisation of psychiatric patients from
which data on domestic violence could potentially be extracted. Search strategy
This systematic review therefore aimed to estimate, first, the Our search strategy followed Meta-analysis of Observational
prevalence (adult lifetime and past year) of being a victim of Studies in Epidemiology (MOOSE) guidelines.14 The protocol
domestic violence among male and female psychiatric patients, for this review was registered with the PROSPERO international
and second, the risk of domestic violence among male and female database of prospectively registered systematic reviews in health
psychiatric patients compared with controls. and social care (www.crd.york.ac.uk/prospero), registration
number CRD42011001281. Eighteen bibliographic databases were
searched from date of inception to 31 March 2011 using a
*Joint first authors. combination of Medical Subject Headings (MeSH) and text words

94
 Domestic violence among psychiatric patients

(see Appendix 1 for a list of the databases used). Terms for

domestic violence were adapted from published Cochrane Records identified by alternative
Records identified through sources 188
protocols and previous literature reviews.9,15,16 No language database searching (hand searches 16; citation tracking
restriction was used and potentially eligible papers were translated 41 067 94; update and reanalysis
and assessments conducted using the English translated versions. of previous review 53;
expert recommendations 35)
The search strategy used for the Medline, EMBASE and PsycINFO
databases is shown in online Appendix DS1. These searches were
supplemented by citation tracking, hand searches, re-examining
and updating an earlier review of victimisation among psychiatric
Records after duplicates
populations,17 and expert recommendations. removed
29 707

Study selection and data extraction

Two reviewers (K.T. and S.O.) screened the downloaded titles and
abstracts against the inclusion criteria; references were taken Records screened
29 707
forward to the next stage of screening if it was unclear whether
Records excluded
they met the inclusion criteria. The same two reviewers then 28 584
assessed the full text of potentially eligible studies in terms of
the inclusion criteria. If it was considered that studies had Full-text articles
collected data on the prevalence and odds of domestic violence assessed for eligibility
1123
but had not presented it, authors were contacted for further
information. Data on study design, sample characteristics,
measurement of domestic violence and outcomes were extracted Full-text articles excluded
by the two reviewers from the included papers and entered in 1081
Reasons for exclusion:
an electronic database. The outcomes of interest for the review Ineligible publication format 5
Studies included
were the prevalence and odds of adulthood lifetime and past year in review
Ineligible study design 15
domestic violence among psychiatric patients. Where possible, Sample under 16 years old 43
42
Sample did not include
outcome measures were extracted separately by gender, mental psychiatric patients 571
health setting and type and severity of violence. Study did not measure
domestic violence 246
Prevalence of domestic
violence could not
Quality appraisal be derived 95
The quality of included studies was independently appraised by
two reviewers (K.T. and S.O.) using criteria adapted from
Fig. 1 Study selection.
validated tools.1820 The reviewers compared scores and resolved
any disagreements before calculating a final appraisal score. The
quality appraisal checklist is shown in online Appendix DS2 and
includes items to assess study design, the representativeness of searches of electronic databases, 7 from citation tracking, 1 from
study samples, the criteria used to measure domestic violence hand searching and 2 from expert recommendations. Only 1 of
and the methods of statistical analysis. Scores for overall study the 42 included papers was published in a language other than
quality and for questions relevant to selection bias and measure- English. We excluded 10 non-English language papers after
ment bias are reported for all studies (see online Table DS1). screening full-text translations, most often because they did not
High-quality papers were defined as those scoring 50% or above measure domestic violence and instead reported on general
on questions assessing selection bias. victimisation.

Key features of included papers

Statistical analysis
Information about the study design, study sample and the
definition and measurement of domestic violence was
summarised. Prevalence estimates (adult lifetime or past year) of
domestic violence were calculated separately by gender and
psychiatric setting when appropriate data were available. Odds
ratios were not calculated because primary studies did not include
control groups.
Results
The study selection process is presented in Fig. 1. Our literature
search yielded 29 707 unique references, of which 28 584 references
were excluded following title and abstract screening. Of the 1123
references that met or potentially met the inclusion criteria,
59 (56 dissertations and 3 journal articles) could not be located.
Thus, 1064 full papers were retrieved and assessed. Forty-two
papers were included in the review (online Table DS1) and 1022
were excluded. Of the 42 included papers, 32 were identified from
Of the 42 papers that examined the prevalence of domestic
violence among psychiatric patients, 36 reported on domestic
violence perpetrated by an intimate partner only (including 7
papers in which the definition was limited to violence perpetrated
by a spouse) and 6 reported on violence perpetrated by either an
intimate partner or other family member. Thirty-two studies
measured lifetime experiences of domestic violence only, 7 past
year domestic violence only and 3 both lifetime and past year
experiences of domestic violence. Further details about the
instruments used to assess domestic violence and the methods
of data collection are provided for each study in online Table DS1.
Regarding study participants, 13 studies included either
psychiatric in-patients only or presented data separately for this
group,2133 16 studies presented data for psychiatric out-patient
samples,22,28,3447 and 4 studies presented data for patients
attending emergency psychiatric departments.4851 Seven studies
were conducted across a range of psychiatric settings and did
not provide data disaggregated by service type.5157 In 5 papers
it was not clear from which type of psychiatric service participants

95
Oram et al
were recruited.5862 Twenty-seven studies were conducted with
women-only samples; one study was conducted with an all-male
sample; 14 studies included both male and female participants
but only 9 provided gender-disaggregated data on domestic
violence.
Psychiatric in-patient samples
Partner violence
Adult lifetime violence. The prevalence of any adult lifetime
partner violence among psychiatric in-patients ranged from 16%
to 94% among women and from 18% to 48% among men (see
online Table DS1). Excluding studies that scored below 50% on
quality appraisal questions relating to selection bias, the median
prevalence of lifetime partner violence was 30% (interquartile
range (IQR) 2639, range 2656) among women.2123,29 No
high-quality paper was identified that reported on lifetime partner
violence among male psychiatric in-patients. Findings for specific
types of partner violence were as follows:
(a) Physical violence: seven studies reported on the lifetime
prevalence of physical partner violence among psychiatric
in-patients.21,22,2831,33 Among high-quality papers the
median prevalence for female in-patients was 26% (IQR 26
41, range 2656).21,22,2931 One poor-quality paper presented
data for men and reported a lifetime prevalence of 18%.30
(b) Sexual violence: one study reported a specific count on the life-
time prevalence of sexual partner violence, which was 16%
among female in-patients; this paper scored below 50% on
quality appraisal questions relating to selection bias.25
(c) Psychological violence: one study reported a specific count on
the lifetime prevalence of psychological partner violence,
which was 94% among female in-patients; this paper scored
below 50% on quality appraisal questions relating to selection
bias.31
Past year violence. Past year prevalence of physical partner
violence ranged in three studies from 33% to 93%;24,26,32 none of
these studies scored 50% or more on selection bias. One high-
quality paper reported that the prevalence of past year physical
violence among female psychiatric in-patients was 18%, but this
estimate combined violence from partners and family members.28
Family violence
Adult lifetime violence. Two studies reported on the prevalence
of adult lifetime family violence among women.21,25 In the only
high-quality study, lifetime prevalence of physical violence among
female in-patients was estimated at 9% for violence perpetrated by
a father and 6% for violence by a brother.21
Past year violence. One study of male and female psychiatric
in-patients reported the prevalence of past year violence by a
family member to be 46%; this paper scored below 50% for
selection bias.24
Psychiatric out-patient samples
Partner violence
Adult lifetime violence. The prevalence of any adult lifetime
partner violence among out-patients ranged from 7% to 81%
among women and from 2% to 6% among men (online Table
DS1). Excluding studies that scored below 50% for selection bias,
the median prevalence was 33% (IQR 2153, range 1581) among
women.22,38,40,42 No high-quality paper was identified that
96
reported on domestic violence among men in this group. Findings
for specific types of violence were:
(a) Physical violence: ten studies assessed lifetime physical partner
violence among women out-patients and reported prevalence
rates of 880%,22,28,3743,47 and two studies reported prev-
alence estimates of 2% and 6% among male out-patients.41,46
Among high-quality papers the median prevalence in female
out-patients was 43% (IQR 2551, range 860).22,40,42
(b) Sexual violence: estimates of the lifetime prevalence of sexual
violence among women in the out-patient group were highly
variable.37,39,40,43 In the only high-quality study the prevalence
for women was 3%.40
(c) Psychological violence: lifetime prevalence of psychological
violence among women out-patients ranged in three studies
from 9% to 72%.40,41,43 Prevalence in the only high-quality
study was 9%.40
Past year partner violence. Fewer data were available on past
year domestic violence. Two high-quality studies assessed past year
physical abuse among female out-patients: one reported a preva-
lence of 16% for physical partner violence,42 the other reported
a prevalence of 11% but combined data for violence from partners
and family members.28
Family violence
Past year family violence. Bengtsson-Tops et al reported that 4%
of a mixed sample of male and female psychiatric out-patients had
been abused in the past year by a family member; however, this
study scored below 50% on quality appraisal questions relating
to selection bias.34
Psychiatric emergency department samples
Partner violence
Adult lifetime violence. The prevalence of adult lifetime domestic
violence ranged from 42% to 60% among women attending
psychiatric emergency departments and was estimated at 8%
among men attenders (see online Table DS1). Only one paper
scored 50% or over on selection bias: this study estimated that
the prevalence among women was 60%.50 No high-quality paper
was identified that reported on domestic violence among men
attenders.
Past year violence. One high-quality study assessed past year
experiences of partner violence among women attending
psychiatric emergency departments and reported the prevalence
rates of past year physical and sexual violence to be 20% and
16% respectively.50
Mixed psychiatric settings
Partner violence
Adult lifetime violence. Seven studies collected data across a
range of psychiatric settings (e.g. in-patient, out-patient,
community, emergency and forensic mental health services) and
did not disaggregate their results according to setting (online Table
DS1). Excluding studies that scored below 50% on quality
appraisal questions relating to selection bias, the median
prevalence of lifetime partner violence among men and women
patients was 26% (IQR 2044, range 2663).52,53,57 Two high-
quality papers also reported gender-specific prevalence estimates.
The first, a large Swedish cross-sectional study that attempted
to question all adult women using psychiatric in-patient and

out-patient services over a 1-week period about their experiences
of violence, additionally estimated that 26% women had ever
experienced violence from a current partner and 23% from a
previous partner.52 The second, conducted in the USA, estimated
that 63% of female psychiatric patients had ever experienced
partner violence (including 50% physical violence and 32% sexual
violence).53 The latter study also estimated that 32% of male
psychiatric patients had experienced partner violence (including
18% physical violence and 4% sexual violence).
Family violence
One high-quality paper reported that, among patients in mixed
psychiatric settings, the prevalence of adult lifetime violence by
a family member was 11%.52
Discussion
The review findings suggest a high prevalence of experiences of
domestic violence among psychiatric patients. Among female
patients, being a victim of lifetime partner violence was reported
by about a third of in-patients and out-patients.2123,29,38,40,42
Only one high-quality paper reported the prevalence of being a
victim of domestic violence among male patients: Chang et al
surveyed patients across a range of psychiatric settings and
estimated that 18% had experienced lifetime physical partner
violence and 4% had experienced lifetime sexual partner violence.53
The review identified only six studies on the prevalence of violence
perpetrated by family members, of which only two were of high
quality: these two studies reported that 11% of a mixed sample
of male and female psychiatric out-patients reported family
violence,52 and that 9% and 6% of female in-patients reported adult
lifetime physical violence by a father or brother respectively.21
No study included non-psychiatric controls representative of
the general population. Thus, although most of the reviewed
studies reported higher estimates of the prevalence of domestic
violence than have been reported for general population
samples,63,64 quantifying the extent to which psychiatric
populations are at greater risk of domestic violence remains
difficult.
Strengths and limitations
The review employed a comprehensive search strategy following
MOOSE guidelines.14 We identified a number of methodological
and conceptual issues in the primary studies that weaken the
estimates of prevalence. Half of the included studies were judged
to score poorly on questions relating to selection bias. We found
that most studies used non-probability sampling and did not
provide information on the representativeness of their samples,
the potential impact of non-participation, or study power.
Furthermore, few studies reported detailed exclusion criteria or
provided information about participants primary diagnoses. We
have therefore carried out a further systematic review to examine
the prevalence and risk of domestic violence in people with
specific psychiatric disorders using different sources of data
(PROSPERO database registration number CRD42011001241
(yet to be published)). The most rigorous study that we identified
in this review, which attempted to survey all women attending
psychiatric in-patient and out-patient services over a 1-week
period about their experiences of domestic violence, reported that
a quarter had experienced abuse from their current partner.52
The exclusion, however, of individuals who were not able to give
informed consent means that the findings cannot be generalised to
the most severely ill patients.
Domestic violence among psychiatric patients
The reliability and comparability of primary studies were also
limited by the methods of data collection and instruments used to
assess domestic violence. Data collection methods varied between
studies and included researcher-administered questionnaires
during face-to-face interviews, self-completed questionnaires and
case file reviews. Face-to-face interviews were used in more than
half of the included studies but may contribute to the under-
detection of violence: a randomised controlled trial of methods
of screening for domestic violence in various healthcare settings
found that women preferred the use of self-completed question-
naires over face-to-face interviews when the same questionnaires
were used.65 Case file reviews are also likely to underestimate
the prevalence of domestic violence experienced by psychiatric
patients: the underdetection and poor recording of domestic
violence, even where routine enquiry has been implemented, is
well documented.10,42,65,66 Future studies should consider using
self-completed questionnaires to assess domestic violence.
Studies also varied with regard to the instruments used to
measure domestic violence. Among studies that employed a
validated instrument to detect domestic violence, the most
commonly used tool was the Conflict Tactics Scale (CTS).67,68
However, authors frequently reported that they made
modifications to this and other instruments without describing
how, if at all, the adapted instruments had been validated. The
reliability and comparability of study findings are likely to have
been reduced by this practice. In addition, although the CTS is
one of the most widely used measures of violence, it has been
criticised for its measurement of acts out of context (i.e. it does
not make it clear whether acts of violence were in attack or in
defence), its gender neutrality and its failure to measure other
forms of partner violence,69 although sexual violence has been
partly addressed in the revised version.68
In 11 papers, authors reported having developed their own
measures to assess domestic violence, and in a further 10 no details
were provided about the instrument used to assess violence.
Moreover, several studies did not enquire specifically about
domestic violence but instead asked participants about their
general experiences of violence. We included those studies in
our review if they reported the identity of the perpetrator and
the age at which abuse occurred. Studies thus differed with regard
to which forms of violence and specific behaviours were enquired
about, which contributed to the observed variation in the
prevalence of victimisation.
Implications of findings
Our review highlights the high prevalence of domestic violence
among people using a range of psychiatric services. It also,
however, draws attention to the lack of high-quality evidence on
domestic violence among psychiatric populations and to the
absence of research comparing psychiatric patients risk of
domestic violence with that of other clinical populations or the
general population. Further evidence gaps are also apparent. First,
despite evidence that emotional abuse is strongly associated
with poor health outcomes,70,71 few studies collected data on
psychiatric patients experiences of psychological violence. Second,
few studies included violence from family members within their
definition of domestic violence. The prevalence of victimisation
by family members in the few studies in which it was measured,
however, suggests that family-perpetrated domestic violence may
be an issue of relevance for some psychiatric patients, as it is
for the general population: in 20102011, a fifth (22%) of all
homicides in London were domestic-related, with the murder of
a parent by a son being the most prevalent.72 Finally, and
despite evidence that suggests that men with severe mental illness
97
Oram et al
are at increased risk of violent victimisation,11,12 few studies
collected data on the prevalence of domestic violence in male
patients. Professionals who work with psychiatric patients across
a range of settings should be aware of the high prevalence of
victimisation among men and women in this group and be able
to identify violence and respond appropriately to their patients
needs.
S. Oram, PhD, K. Trevillion, BSc, Section of Womens Mental Health, Institute
of Psychiatry, Kings College London; G. Feder, MD, FRCGP, School of Social and
Community Medicine, Academic Unit of Primary Health Care, University of Bristol;
L. M. Howard, PhD, MRCPsych, Section of Womens Mental Health, Institute
of Psychiatry, Kings College London, UK
Correspondence: Louise M. Howard, Section of Womens Mental Health,
Institute of Psychiatry, Kings College London, PO31, David Goldberg
Centre, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. Email:
louise.howard@kcl.ac.uk
First received 2 Feb 2012, final revision 19 Jul 2012, accepted 20 Aug 2012
Funding
This paper presents independent research commissioned by the National Institute for
Health Research (NIHR) under its Programme Grants for Applied Research scheme
(RP-PG-0108-10084). The authors are all supported by the NIHR Programme Grants for
Applied Research scheme (RP-PG-0108-10084). L.M.H. is also supported by the NIHR South
London and Maudsley National Health Service Foundation Trust Biomedical Research
Centre Mental Health.
Acknowledgements
We thank the experts in this area who responded so helpfully in our request for data. We
also gratefully acknowledge Fraser Anderson for her assistance during the summer of
2011, Mauricio Moreno for technical support and Seynam Kluvitse for administrative
assistance. We are also grateful to Michael Dewey, Monika Janosik, Leo Koeser, Sharron
Leung, Kazuyo Machiyama, Mauricio Moreno, Oliver Schauman and Tracy Teng for
translating articles that were published in non-English languages.
Appendix 1
Electronic databases searched for systematic review
Biomedical databases
Academic Search Complete, British Nursing Index, CINAHL, Cochrane,
EMBASE, Health Management Information Consortium (HMIC), Medline,
Maternity and Infant Care, PsycINFO, Science Direct, Web of Science
(including Science Citation Index, Social Sciences Citation Index, Arts &
Humanities Citation Index, and Conference Proceedings Citation Index
for Science and for Social Science and Humanities)
Social sciences databases
Applied Social Sciences Index and Abstracts, International Bibliography of
the Social Sciences, JSTOR, Sociological Abstracts
Theses and dissertations
DART-Europe E Theses Portal, Electronic Theses Online Service (EThOS),
Networked Digital Library of Theses and Dissertations
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 The British Journal of Psychiatry (2013)
202, 9499. doi: 10.1192/bjp.bp.112.109934

Data supplement

Appendix DS1

Search strategy for electronic searches of the Medline, EMBASE and PsycINFO databases
1. Domestic violence/
2. Family violence/
3. Partner abuse/
4. Partner violence/
5. Spouse abuse/
6. Battered women/
7. ((abus$ OR batter$ OR violen$ OR beat$) adj5 (domestic OR partner$ OR family OR families OR spouse OR woman OR women OR men OR man OR
female$ OR male$ OR wife OR wives OR husband$ OR boyfriend$ OR girlfriend$ OR elder$ OR brother$ OR sister$ OR father$ OR mother$ OR
daughter$ OR son$ OR carer$).mp.)
8. (domestic adj5 homicid$).mp
9. 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8
10. Mental Disorder/
11. Mental illness/
12. Mental health/
13. (Mental$ adj2 (problem$ OR difficult$ OR disorder$ OR ill$ OR health).mp.)
14. Mental health services/
15. Community Mental Health Services/
16. ((mental OR psychiatr$ OR psycholog$) adj3 (inpatient$ OR outpatient$ OR hospital$ OR clinic$ OR service$ OR ward$ OR healthcare).mp)
17. Psychiatr$
18. Psycholog$
19. Schiz$
20. Psychos$
21. Psychot$
22. Bipolar
23. Depress$
24. Mania$ OR manic$
25. Neurosis OR psychoneurosis
26. Personality disorder/ OR anankastic personality disorder/ OR antisocial personality disorder/ OR avoidant personality disorder/ OR borderline
personality disorder/ OR compulsive personality disorder/ OR dependent personality disorder/ OR histrionic personality disorder/ OR narcissistic
personality disorder/ OR obsessive compulsive personality disorder/ OR paranoid personality disorder/ OR passive-aggressive personality disorder/
OR schizoid personality disorder/ OR schizotypal personality disorder/) OR ((anankastic OR asocial OR antisocial OR avoidant OR borderline OR
dependent OR dissocial OR histrionic OR narcissistic OR obsessive OR compulsive OR paranoid OR passive-aggressive OR psychopath$ OR
sadist$ OR sadomasochistic OR schizo$ OR sociopath$) adj person$).tw. OR (personality AND disorder$r) OR psychopath$.tw OR sociopath$.tw
27. Eating disorders/ OR Anorexia Nervosa/ OR Binge-Eating Disorder/or Bulimia Nervosa/ OR ((anorexi$ OR bulimi$) AND nervosa) OR eating disorder$
OR binge-eat$ OR (bing$ adj eat$) OR (compulsive adj (eat$ or vomit$ or purg$))
28. ((Delusional OR paranoi$ OR mood OR neurotic OR stress OR reactive OR combat OR somatoform OR somatization OR somatisation OR anxiety OR
phobic OR obsessive-compulsive OR adjustment OR dissociat$) adj2 disorder$))
29. 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 OR 19 OR 20 OR 21 OR 22 OR 23 OR 24 OR 25 OR 26 OR 27 OR 28
30. 9 AND 29

1
 Appendix DS2

Quality appraisal instrument

Scoring: 0 study does not meet criteria/answer question; 1 study partially meets criteria/gives a partially satisfactory answer to the question;
2 study fully meets criteria/gives a fully satisfactory answer to the question.

Part 1 Screening questions

Question Comments 0 1 2

1 Did the study ask a clearly focused question?

2 Is the study design appropriate for the research question?

Continue only if the score on each of the above questions is 1 or more

Part 2 Risk of selection bias

3 Is the sampling method appropriate for the research question?

4 Are participant criteria appropriate?
5 Is the sample size appropriate?
6 Is the study sample representative of the population of interest?
7 Does the level of non-participation risk introducing bias?

Part 3 Risk of measurement and reporting bias

8 Are suitable/standard criteria used for measurement of domestic violence?

9 Are known confounders accounted for by study design?
10 Are known confounders accounted for in the analyses?
11 Are the statistical tests used to assess the main outcomes appropriate?
12 Are the estimates reported with confidence intervals and in detail by sub-group (if appropriate)?
13 Are statistically non-significant results presented?
14 Are data for relevant variables complete?

Part 4 Additional questions

15 Was the conduct of the fieldwork appropriate to the study setting?

16 Were ethical considerations appropriately considered?
17 Do the findings support the conclusions?
18 Are the strengths and weaknesses of the research discussed?

2
 Table DS1 Characteristics and reported outcomes of included studies
Author (year)ref Country Sample Method Definition of domestic violence Results Quality scores

Psychiatric in-patient sample

Bryer (1987)21 USA 68 female psychiatric Cross-sectional survey
in-patients (missing Violence assessed by self-
data for 2 participants) administered questionnaire
using the authors questions
Domestic violence derived from
information on age of abuse
and perpetrator of violence
Carlile (1991)22 South Africa 152 female psychiatric Cross-sectional survey
patients (64 in-patients, Domestic violence assessed
88 out-patients) during interview using the
authors questions
Carmen (1984)23 USA 188 male and female Case file review
psychiatric in-patients Domestic violence assessed
(66 men, 122 women) on basis of information recorded
in case files
Cascardi (1996)24 USA 69 male and female Cross-sectional survey
psychiatric in-patients Domestic violence assessed by
(33 men, 36 women) self-administered questionnaire
using the Conflict Tactics Scale
Chandra (2003)25 India 146 female psychiatric Cross-sectional survey
in-patients Sexual violence assessed during
interview using the Sexual
Experiences Survey
Domestic violence derived from
subsequent qualitative data on
age of abuse and perpetrator
of violence
Heru (2006)26 USA 110 male and female Cross-sectional survey
psychiatric in-patients Domestic violence assessed by
(44 men, 66 women) self-administered questionnaire
using the Revised Conflict
Tactics Scale
Adulthood lifetime physical
or sexual violence by a spouse,
intimate partner or nuclear
family member
Adulthood lifetime physical
violence by a spouse
Adulthood lifetime physical or
sexual violence within a marital
relationship
Past year physical violence by
an intimate partner or family
member
Adulthood lifetime sexual
violence by an intimate partner
or a relative
Past year physical, sexual or
psychological violence by an
intimate partner
Lifetime physical violence Total score 24/40
17/66 (26%) women reported physical violence by a spouse or Selection bias 7/14
intimate partner Measurement bias 8/14
6/66 (9%) women reported physical violence by a father,
4/66 (6%) by a brother
Lifetime sexual violence
6/66 (9%) women reported sexual violence by a family member
(disaggregated data on sexual violence by a spouse or intimate
partner was not presented)
36/64 (56%) women reported physical violence by a spouse Total score 24/40
Selection bias 7/14
Measurement bias 9/14
41/122 (34%) women reported violence by a spouse Total score 22/40
(data not presented for men) Selection bias 7/14
Measurement bias 6/14
27 (63%) of the 43 men and women with an intimate partner Total score 26/40
reported physical violence Selection bias 6/14
22 (46%) of 48 men and women who lived with a family Measurement bias 13/14
member reported physical violence
Data not gender-disaggregated
24/146 (16%) women reported sexual violence by an Total score 19/40
intimate partner Selection bias 6/14
10/146 (7%) women reported sexual violence by a relative Measurement bias 7/14
Past year physical violence Total score 26/40
61/66 (92%) women reported physical violence by an Selection bias 6/14
intimate partner Measurement bias 12/14
57/66 (86%) women reported severe physical violence
41/44 (93%) men reported physical violence by an intimate partner
39/44 (89%) men reported severe physical violence
Past year sexual violence
12/66 (18%) women reported sexual violence by an intimate
partner
13/44 (30%) men reported sexual violence by an intimate partner
Past year psychological violence
61/66 (92%) women reported psychological violence by an
intimate partner
36/44 (82%) men reported psychological violence by an intimate
partner

(Continued)

3
4
Table DS1 (Continued)
Author (year)ref Country Sample Method Definition of domestic violence Results Quality scores
27
Hoffman (1988) Canada 50 male and female Cross-sectional survey Adulthood lifetime physical, 19/25 (76%) women reported any violence by an intimate Total score 24/40
psychiatric in-patients Domestic violence assessed sexual and psychological partner Selection bias 6/14
(25 men, 25 women) during interviews using the violence by an intimate partner 12/25 (48%) men reported any violence by an intimate partner Measurement bias 10/14
Conflict Tactics Scale
Hudson Scholle USA 317 female house- Cross-sectional survey Adulthood lifetime and past year Lifetime physical violence Total score 30/40
(1998)28 holders who screened Domestic violence assessed physical violence by an intimate 7/11 (64%) women reported physical violence by an intimate Selection bias 10/14
positive for depression during interviews using the partner or family member partner/family member Measurement bias 11/14
and reported on their Conflict Tactics Scale Past year physical violence
use of mental health 2/11 (18%) women reported physical violence by an intimate
services in the past year partner/family member
(11 reported previous
in-patient admission)
Husain (1983)29 USA 23 female forensic Cross-sectional survey Adulthood lifetime physical 6/23 (26%) women reported physical violence by a spouse Total score 24/40
psychiatric patients Domestic violence assessed violence by a spouse Selection bias 9/14
during interviews by social workers Measurement bias 8/14
and psychiatrists; no instrument
specified
Post (1980)30 USA 60 male and female Cross-sectional survey Adulthood lifetime physical 29/60 (48%) men and women reported physical violence Total score 18/40
psychiatric in-patients Domestic violence assessed violence by an intimate partner by an intimate partner Selection bias 6/14
(22 men, 38 women) during interviews using the 25/38 (66%) women reported physical violence by an intimate Measurement bias 6/14
authors questions partner
4/22 (18%) men reported physical violence by an intimate partner
Sansone (2007)31 USA 113 female psychiatric Cross-sectional survey Adulthood lifetime physical or Lifetime physical violence Total score 26/40
in-patients (missing data Domestic violence assessed by psychological violence by an 91/109 (83%) women reported physical violence by an intimate Selection bias 6/14
for 4 participants) self-administered questionnaire intimate partner partner Measurement bias 11/14
using the Sexual Violence Against Lifetime psychological violence
Women Scale (non-zero score) 103/109 (94%) women reported psychological violence by
an intimate partner
Weizmann-Henelius Finland 91 female violent Casecontrol study (cases were Past year physical and sexual 4/12 (33%) women reported any violence by an intimate partner Total score 23/40
(2004)32 incarcerated or female violent offenders violence by an intimate partner Selection bias 5/14
hospitalised offenders incarcerated or hospitalised Measurement bias 10/14
or community controls during a 12-month period and
(12 women were controls were non-offender women
forensic psychiatric recruited from community
in-patients) education or evening courses)
Domestic violence assessed during
interview using the authors
questions
Zanarini (1999)33 USA 362 male and female Cross-sectional survey Adulthood lifetime physical 108/362 (30%) men and women reported physical violence Total score 27/40
psychiatric in-patients Adulthood violence assessed violence by an intimate partner by an intimate partner (data not gender-disaggregated) Selection bias 7/14
(83 men, 279 women) during interviews using the Measurement bias 11/14
Abuse History Interview; domestic
violence derived from information
on perpetrator of violence

(Continued)
 Table DS1 (Continued)
Author (year)ref Country Sample Method Definition of domestic violence Results Quality scores

Psychiatric out-patient sample

Bengtsson-Tops Sweden 174 male and female Cross-sectional survey Adulthood lifetime and past year Lifetime partner violence (any) Total score 21/40
(2011)34 psychiatric out-patients Domestic violence assessed by physical, sexual or psychological 9/174 (5%) men and women reported any current partner Selection bias 5/14
(75 men, 99 women) self-administered questionnaire violence by a partner or family violence Measurement bias 9/14
using the Composite Abuse member 27/174 (16%) men and women reported any violence by
Scale and authors questions a former partner
25/174 (14%) men and women reported any violence by
a family member
7/174 (4%) men and women reported any violence by
another relative
Past year violence (any)
9/174 (5%) men and women reported any current partner violence
11/174 (6%) men and women reported any violence by a former partner
7/174 (4%) men and women reported any violence by a family member
2/174 (1%) men and women reported any violence by another relative
Past year physical violence
7/174 (4%) men and women reported current physical partner violence
6/174 (3%) men and women reported physical violence by a former partner
5/174 (3%) men and women reported physical violence by a family member
1/174 (0%) men and women reported physical violence by another relative
Past year sexual violence
2/174 (1%) men and women reported current sexual partner violence
5/174 (3%) men and women reported sexual violence by a former partner
3/174 (2%) men and women reported sexual violence by a family member
0/174 (0%) men and women reported sexual violence by another relative
Past year psychological violence
7/174 (4%) men and women reported current psychological partner violence
6/174 (3%) men and women reported psychological violence by a former partner
5/174 (3%) men and women reported psychological violence by a family member
2/174 (1%) men and women reported psychological violence by another relative
Data not gender-disaggregated
Carlile (1991)22 South Africa 152 female psychiatric Cross-sectional survey Adulthood lifetime physical 38/88 (43%) women reported physical violence by a spouse Total score 24/40
patients (88 out-patients, Domestic violence assessed violence by a spouse Selection bias 7/14
64 in-patients) during interview using the authors Measurement bias 9/14
questions
Ford (2008)35 USA 38 female community Cross-sectional survey Adulthood lifetime violence by 20/38 (53%) women reported any violence by an intimate Total score 22/40
mental health patients Domestic violence assessed an intimate partner; type of partner Selection bias 4/14
during interviews using the violence not specified Measurement bias 11/14
Traumatic Events Screening
Inventory
Goodman (1995)37 USA 99 episodically Cross-sectional survey Adulthood lifetime physical and Lifetime physical violence Total score 27/40
homeless female Domestic violence assessed sexual violence by an intimate 79/99 (80%) women reported physical violence by an intimate Selection bias 5/14
community mental during interviews using the partner partner Measurement bias 12/14
health patients Conflict Tactics Scale and Russell Lifetime sexual violence
Interview 40/99 (40%) women reported sexual violence by an intimate
partner

(Continued)

5
6
Table DS1 (Continued)
Author (year)ref Country Sample Method Definition of domestic violence Results Quality scores

Hatters Friedman USA 53 female community Cross-sectional survey Adulthood lifetime violence 36/53 (68%) women reported any violence by an intimate Total score 19/40
(2011)36 mental health patients Domestic violence assessed (physical, sexual or threatened) partner Selection bias 4/14
during interviews using the by an intimate partner Measurement bias 7/14
authors questions
Herman (1986)38 USA 190 psychiatric Case file review Adulthood lifetime physical and 24/105 (23%) women reported any violence by a spouse Total score 24/40
out-patients (85 men, Domestic violence assessed on sexual violence by a spouse (data not presented for men) Selection bias 10/14
105 women) basis of information recorded in Measurement bias 4/14
case files
Hudson Scholle USA 317 female Cross-sectional survey Adulthood lifetime and past year Lifetime physical violence Total score 30/40
(1998)28 householders screened Domestic violence assessed physical violence by an intimate 98/167 (59%) women reported physical violence by an Selection bias 10/14
positive for depression during interviews using the partner or family member intimate partner/family member Measurement bias 11/14
and self-report on past Conflict Tactics Scale Past year physical violence
year mental health 19/167 (11%) women reported physical violence by an
service use (167 reported intimate partner/family member
previous out-patient
visits)
Johnston-McCabe USA 46 deaf and hard Cross-sectional survey Adulthood lifetime physical, Lifetime physical violence Total score 22/40
(2011)39 of hearing female Domestic violence assessed sexual or psychological violence 26/46 (56%) women reported physical violence Selection bias 3/14
community mental by interpreter-assisted or by an intimate partner by an intimate partner Measurement bias 11/14
health patients self-administered questionnaires Lifetime sexual violence
using an adapted version of the 12/46 (26%) women reported sexual violence by an
Conflict Tactics Scale intimate partner
Lifetime psychological violence
33/46 (72%) women reported psychological violence by
an intimate partner
Leithner (2009)40 Austria 424 female patients Cohort study Adulthood lifetime physical, Lifetime violence (any) Total score 23/40
from a womens Domestic violence assessed sexual and psychological violence 62/424 (15%) women reported any violence by an intimate Selection bias 8/14
psychosomatic during interviews; no instrument by an intimate partner partner Measurement bias 8/14
out-patient clinic specified Lifetime physical violence
38/424 (9%) women reported physical violence by an intimate
partner
Lifetime sexual violence
11/424 (3%) women reported sexual violence by an intimate
partner
Lifetime psychological violence
44/424 (10%) women reported psychological violence by an
intimate partner
Lipschitz (1996)41 USA 120 male and female Cross-sectional survey Adulthood lifetime physical 32/120 (27%) men and women reported physical violence Total score 20/40
psychiatric out-patients Domestic violence assessed by violence by a spouse or by a spouse/intimate partner Selection bias 6/14
(34 men, 86 women) self-administered questionnaire intimate partner 30/86 (35%) women reported physical violence by a spouse/ Measurement bias 6/14
using the Traumatic Events intimate partner
Questionnaire 2/34 (6%) men reported physical violence by a spouse/intimate
partner

(Continued)
 Table DS1 (Continued)
Author (year)ref Country Sample Method
42
Morgan (2010) UK 71 female community Cross-sectional survey
mental health patients Domestic violence assessed by
(missing data for self-administered questionnaire
1 participant) using the authors questions
Ramanathan (1996)43 India 332 female psychiatric Cross-sectional survey
out-patients Domestic violence assessed
during interviews; no instrument
specified
Surrey (1990)44 USA 140 female psychiatric Cross-sectional survey
out-patients Violence assessed by
self-administered questionnaire
using the Life Experiences
Questionnaire; domestic violence
derived from information on age at
abuse and perpetrator of violence
Swett (1991)45 USA 189 female psychiatric Cross-sectional survey
out-patients Violence assessed by
self-administered questionnaire
using the Life Experiences
Questionnaire; domestic violence
derived from information on age at
abuse and perpetrator of violence
Swett (1990)46 USA 125 male psychiatric Cross-sectional survey
out-patients Violence assessed by
self-administered questionnaire;
domestic violence derived from
information on age at abuse and
perpetrator of violence
(no instrument specified)
Vahip (2006)47 Turkey 100 female psychiatric Cross-sectional survey
out-patients Method of assessing domestic
violence is unclear, authors
questions used
Definition of domestic violence
Adulthood lifetime, past year
and during pregnancy physical
violence by an intimate partner
Adulthood lifetime psychological
violence by an intimate partner
Adulthood lifetime physical,
sexual or psychological violence
by a spouse
Adulthood lifetime physical
or sexual violence by a spouse
Adulthood lifetime physical
or sexual violence by a spouse
Adulthood lifetime physical
or sexual violence by an intimate 2/125 (2%) men reported physical violence by an intimate
partner
Adulthood lifetime physical
violence by an intimate partner
Results Quality scores
Lifetime physical violence Total score 32/40
42/70 (60%) women reported physical violence by an intimate Selection bias 12/14
partner Measurement bias 11/14
Past year physical violence
11/70 (16%) women reported physical violence by an intimate
partner
Physical violence during pregnancy
14/70 (20%) women reported physical violence by an intimate
partner
Lifetime psychological violence
38/70 (54%) women reported threatening behaviour by an intimate
partner
57/70 (81%) women reported controlling behaviour by an intimate
partner
Lifetime physical violence Total score 18/40
25/332 (8%) women reported physical violence by a spouse Selection bias 5/14
Lifetime sexual violence Measurement bias 9/14
3/332 (1%) women reported sexual violence by a spouse
51/332 (15%) women reported psychological violence by a spouse
10/140 (7%) women reported any violence by a spouse Total score 24/40
Selection bias 6/14
Measurement bias 11/14
17/189 (9%) women reported any violence by a spouse Total score 22/40
Selection bias 6/14
Measurement bias 11/14
Lifetime physical violence Total score 21/40
Selection bias 6/14
partner Measurement bias 7/14
Lifetime sexual violence
0/125 (0%) men reported sexual violence by an intimate partner
62/100 (62%) women reported physical violence by an Total score 3/40
intimate partner Selection bias 5/14
Measurement bias 8/14

(Continued)

7
8
Table DS1 (Continued)
Author (year)ref Country Sample Method Definition of domestic violence Results Quality scores

Psychiatric emergency department sample

Briere (1997)48 USA 93 female psychiatric Case file review Adulthood lifetime physical 39/93 (42%) women reported physical violence by an intimate Total score 19/40
emergency room Domestic violence assessed violence by an intimate partner partner Selection bias 2/14
attenders on basis of information recorded Measurement bias 10/14
in case files
Currier (2000)49 USA 162 male and female Cross-sectional survey Adulthood lifetime physical 35/162 (22%) male and female emergency department Total score 6/40
psychiatric emergency Domestic violence assessed violence by a spouse or intimate attenders reported physical violence by a spouse/intimate Selection bias 3/14
room attenders during interview using the partner partner 17/36 (47%) of women reported physical violence by Measurement bias 8/14
(gender-disaggregated authors questions a spouse/intimate partner
data available for 84 4/48 (8%) men reported physical violence by a spouse/intimate
participants: 48 men, partner
36 women)
Owens (2007)50 USA 216 female psychiatric Cross-sectional survey Adulthood lifetime and past Lifetime physical violence Total score 29/40
emergency department Domestic violence assessed by year physical and sexual 129/216 (60%) women reported physical violence by an Selection bias 10/14
attenders self-administered questionnaire violence by an intimate partner intimate partner Measurement bias 10/14
using questions derived from Adulthood lifetime psychological Past year physical violence
the Abuse Assessment Screen, violence by an intimate partner 43/216 (20%) women reported physical violence by an
Conflict Tactics Scale and intimate partner
Womens Experiences of Battering Lifetime sexual violence
84/216 (39%) women reported sexual violence by an
intimate partner
Past year sexual violence
34/216 (16%) women reported sexual violence by an
intimate partner
Lifetime psychological violence
70/216 (32%) women reported psychological violence by
an intimate partner
Paranjape (2006)51 USA 153 female hospital Cross-sectional survey Adulthood lifetime violence 5/10 (50%) women reported any violence by an intimate Total score 28/40
patients (10 emergency Domestic violence assessed (physical, sexual or psychological) partner Selection bias 5/14
psychiatric care users) during interviews using the Index by an intimate partner Measurement bias 13/14
of Spouse Abuse Physical
and Non-Physical subscales
Mixed psychiatric settings
Bengtsson-Tops Sweden 1362 female psychiatric Cross-sectional survey Adulthood lifetime physical, 349/1362 (26%) women reported any violence from Total score 27/40
(2005)52 in-patients and out- Domestic violence assessed by sexual, psychological or a current partner Selection bias 11/14
patients self-administered questionnaire economic abuse by a current/ 315/1362 (23%) women reported any violence from Measurement bias 8/14
using the authors questions former partner or family member a former partner
Domestic violence derived from 151/1362 (11%) women reported any violence from relatives
information on age at abuse and
perpetrator

(Continued)
 Table DS1 (Continued)
Author (year)ref Country Sample Method Definition of domestic violence Results Quality scores
53
Chang (2011) USA 428 male and female Cross-sectional survey Adulthood lifetime physical, Lifetime violence (any) Total score 29/40
psychiatric in-patients, Domestic violence assessed by sexual or psychological violence 169/270 (63%) women reported any violence by an intimate Selection bias 7/14
out-patients and emer- self-administered questionnaire by an intimate partner partner Measurement bias 12/14
gency room attenders using the Abuse Assessment Past year physical or sexual 50/158 (32%) men reported any violence by an intimate partner
(158 men, 270 women) Screen violence by an intimate partner Lifetime physical violence
134/270 (50%) women reported physical violence by an intimate
partner
29/158 (18%) men reported physical violence by an intimate
partner
Lifetime sexual violence
87/270 (32%) women reported sexual violence by an intimate
partner
7/158 (4%) men reported sexual violence by an intimate partner
Lifetime psychological violence
106/270 (39%) women reported psychological violence by an
intimate partner
42/158 (27%) men reported psychological violence by an intimate
partner
Past year physical violence
34/270 (13%) women reported physical violence by an intimate
partner
10/158 (6%) men reported physical violence by an intimate partner
Past year sexual violence
20/270 (7%) women reported sexual violence by an intimate
partner
4/158 (2%) men reported sexual violence by an intimate partner
Da Silva (1991)55 Portugal 40 female patients Cross-sectional survey Adulthood lifetime physical 20/40 (50%) women reported physical violence by an intimate Total score 16/40
recruited from a Domestic violence assessed violence by an intimate partner partner Selection bias 4/14
psychiatric day hospital during interview using the Measurement bias 7/14
and in-patient unit authors questions
Dienemann (2000)54 USA 82 female psychiatric Cross-sectional survey Adulthood lifetime and past year Lifetime violence (any) Total score 22/40
in-patients, out-patients Domestic violence assessed physical and sexual violence by 50/81 (61%) women reported any violence by an intimate Selection bias 3/14
and members of during interview using the an intimate partner partner Measurement bias 10/14
community support Abuse Assessment Screen Past year violence (any)
group for people with 11/81 (13%) women reported any violence by an intimate
depression (missing data partner
for 1 participant) Lifetime physical violence
30/81 (37%) women reported physical violence by an intimate
partner
Past year physical violence
10/81 (12%) women reported physical violence by an intimate
partner
Lifetime sexual violence
24/81 (29%) women reported sexual violence by an intimate
partner
Past year sexual violence
5/81 (6%) women reported sexual violence by an intimate partner

(Continued)

9
10
Table DS1 (Continued)
Author (year)ref Country Sample Method Definition of domestic violence Results Quality scores
56
McPherson (2007) USA 379 female psychiatric Cohort study (baseline data Past year physical violence by 72/379 (19%) women reported physical violence by an Total score 32/40
in-patients and extracted) an intimate partner intimate partner Selection bias 11/14
out-patients Domestic violence assessed Measurement bias 12/14
during interviews using adapted
version of the Conflict Tactics Scale
Paranjape (2005)51 USA 153 female hospital Cross-sectional survey Adulthood lifetime violence 31/49 (63%) female non-emergency psychiatric care users Total score 28/40
patients Domestic violence assessed (physical, sexual or psychological) reported any violence by an intimate partner Selection bias 5/14
(49 non-emergency during interviews using the by an intimate partner Measurement bias 13/14
psychiatric care users) Index of Spouse Abuse Physical
and Non-Physical subscales
Yellowlees (1994)57 Australia 567 men and women Case file review Adulthood lifetime physical 83/567 (15%) men and women reported physical violence Total score 22/40
receiving psychiatric Domestic violence assessed on violence by an intimate partner by an intimate partner (data not gender-disaggregated) Selection bias 9/14
care in community, basis of information recorded Measurement bias 6/14
hospital and prison in case files
Psychiatric setting unclear
Brown (2009)58 Australia 98 male and female Cross-sectional survey Past year physical domestic 6/53 (11%) female attenders reported physical violence by Total score 27/40
youth mental health Domestic violence assessed violence by an intimate partner an intimate partner Selection bias 8/14
service attenders during interview using Youth 7/45 (16%) male attenders reported physical violence by Measurement bias 10/14
(45 male, 53 female) Risk Behavior Survey an intimate partner
Osgood (2000)59 USA 59 female patients Case file review Adulthood lifetime physical 14/59 (24%) women reported any violence by an intimate Total score 23/40
from two psychiatric Domestic violence assessed or sexual violence by an intimate partner Selection bias 8/14
facilities during case file review partner Measurement bias 6/14
Tham (1995)60 UK 184 men and women Cross-sectional survey Past year violence by an 45/184 (24%) women reported any violence by an intimate Total score 19/40
presenting to psychiatric Domestic violence assessed intimate partner; type of partner (data not presented for men) Selection bias 6/14
services during interviews using the violence not specified Measurement bias 7/14
authors questions
Waller (1991)61 UK 67 female patients Cross-sectional survey Adulthood lifetime sexual 8/67 (12%) women reported sexual violence by an Total score 18/40
being treated by Sexual violence assessed for violence by an intimate partner intimate partner Selection bias 4/14
psychiatrist for eating 1/3 sample by self-administered Measurement bias 7/14
disorder Sexual Events Questionnaire, for
remaining 2/3 assessed during
treatment interviews
Domestic violence derived from
information on age at abuse and
perpetrator of violence
Weingourt (1990)62 USA 53 women being Cross-sectional survey Adulthood lifetime sexual 33/53 (62%) women reported sexual violence by an Total score 22/40
treated for anxiety or Domestic violence assessed violence by an intimate partner intimate partner Selection bias 5/14
depressive disorder during interviews using the Measurement bias 10/14
authors questions
Prevalence of experiences of domestic violence among
psychiatric patients: systematic review
S. Oram, K. Trevillion, G. Feder and L. M. Howard
BJP 2013, 202:94-99.
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