Can mental health treatments help prevent or reduce intimate partner violence in low- and middle-income countries? A systematic review

被引:46
作者
Tol, W. A. [1 ,2 ]
Murray, S. M. [1 ]
Lund, C. [3 ,4 ]
Bolton, P. [1 ,5 ]
Murray, L. K. [1 ]
Davies, T. [3 ]
Haushofer, J. [6 ,7 ,8 ,9 ]
Orkin, K. [10 ,11 ,12 ]
Witte, M. [11 ,13 ]
Salama, L. [1 ]
Patel, V. [14 ,15 ]
Thornicroft, G. [4 ]
Bass, J. K. [1 ]
机构
[1] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, 624 N Broadway,HH795, Baltimore, MD 21205 USA
[2] HealthRight Int, Peter C Alderman Program Global Mental Hlth, New York, NY 10012 USA
[3] Univ Cape Town, Dept Psychiat & Mental Hlth, Alan J Flisher Ctr Publ Mental Hlth, Cape Town, South Africa
[4] Kings Coll London, Inst Psychiat Psychol & Neurosci, Ctr Global Mental Hlth, Hlth Serv & Populat Res Dept, London, England
[5] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA
[6] Princeton Univ, Dept Psychol, Princeton, NJ 08544 USA
[7] Princeton Univ, Woodrow Wilson Sch Publ & Int Affairs, Princeton, NJ 08544 USA
[8] Natl Bur Econ Res, Cambridge, MA 02138 USA
[9] Busara Ctr Behav Econ, Nairobi, Kenya
[10] Univ Oxford, Blavatnik Sch Govt, Oxford, England
[11] Univ Oxford, Ctr Study African Econ, Oxford, England
[12] Univ Oxford, Merton Coll, Oxford, England
[13] Univ Oxford, Dept Econ, Oxford, England
[14] Harvard Med Sch, Dept Global Hlth & Social Med, Boston, MA USA
[15] Harvard Chan Sch Publ Hlth, Dept Global Hlth & Populat, Boston, MA USA
关键词
Mental health; Intimate partner violence; Low- and middle-income countries; Treatment; Multisectoral interventions; Systematic review; BRIEF PSYCHOLOGICAL TREATMENT; RANDOMIZED CONTROLLED-TRIAL; GENDER-BASED VIOLENCE; FEMALE SEX WORKERS; GLOBAL PREVALENCE; MALE PERPETRATORS; UN MULTICOUNTRY; PRIMARY-CARE; WOMEN; INTERVENTION;
D O I
10.1186/s12905-019-0728-z
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Epidemiological research suggests an interrelationship between mental health problems and the (re)occurrence of intimate partner violence (IPV). However, little is known about the impact of mental health treatments on IPV victimization or perpetration, especially in low- and middle-income countries (LMIC). We conducted a systematic review to identify prospective, controlled studies of mental health treatments in LMIC. We defined 'mental health treatment' as an intervention for individuals experiencing mental ill health (including substance misuse) including a substantial psychosocial or pharmacological component. Studies had to measure a mental health and IPV outcome. We searched across multi-disciplinary databases using a structured search strategy. Screening of title/abstracts and full-text eligibility assessments were conducted by two researchers independently, data were extracted using a piloted spreadsheet, and a narrative synthesis was generated. We identified seven studies reported in 11 papers conducted in five middle-income countries. With the exception of blinding, studies overall showed acceptable levels of risk of bias. Four of the seven studies focused on dedicated mental health treatments in various populations, including: common mental disorders in earthquake survivors; depression in primary care; alcohol misuse in men; and alcohol misuse in female adult sex workers. The dedicated mental health treatments targeting depression or alcohol misuse consistently reduced levels of these outcomes. The two studies targeting depression also reduced short-term IPV, but no IPV benefits were identified in the two alcohol-focused studies. The other three studies evaluated integrated interventions, in which a focus on substance misuse was part of efforts to reduce HIV/AIDS and violence against particularly vulnerable women. In contrast to the dedicated mental health interventions, the integrated interventions did not consistently reduce mental ill health or alcohol misuse compared to control conditions. Too few studies have been conducted to judge whether mental health treatments may provide a beneficial strategy to prevent or reduce IPV in LMIC. Key future research questions include: whether promising initial evidence on the effects of depression interventions on reducing IPV hold more broadly, the required intensity of mental health components in integrated interventions, and the identification of mechanisms of IPV that are amenable to mental health intervention.
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页数:15
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