Summary DSM-style diagnostic criteria often require distress or impairment. We distinguish four questions: why a condition belongs in psychiatric classification, whether an individual meets its criteria, how significant it is for that person and what response is warranted. Distress and impairment should not be universal requirements for individual diagnosis.
Background Intimate partner violence (IPV) is a major global health and human rights issue. However, the association between IPV and specific mental disorders across different life stages, including pregnancy and postpartum, remains insufficiently quantified. Aims This systematic review and meta-analysis aimed to assess the associations between IPV and mental disorders among women in the general population, pregnant women and postpartum women. Method We searched six databases to identify cross-sectional, case–control and cohort studies published between 1 January 1980 and 13 June 2024. A random-effects meta-analysis model was performed to derive the pooled odds ratios and 95% confidence intervals. Results Of 7326 records identified, 82 studies with a total of 140 286 participants were included. For women in the general population, lifetime IPV was significantly associated with depression (odds ratio 2.26, 95% CI 1.83–2.79, p < 0.0001; class 1; moderate). Past-year IPV also demonstrated significant associations with depression (odds ratio 2.36, 95% CI 1.61–3.45, p < 0.0001; class 3; very low) and anxiety (odds ratio 2.85, 95% CI 1.61–5.05, p = 0.0003; class 3; low) among women in the general population. IPV during pregnancy was notably associated with depression (odds ratio 3.59, 95% CI 2.48–5.20, p < 0.0001; class 2; very low) and anxiety (odds ratio 3.27, 95% CI 2.60–4.10, p < 0.0001; class 1; moderate) in pregnant women. For postpartum women, lifetime IPV exposure was significantly linked to depression (odds ratio 2.09, 95% CI 1.54–2.83, p < 0.0001; class 3; moderate). Conclusions IPV is associated with depression, anxiety and eating disorders among women in the general population, pregnant women and postpartum women. Tackling the root causes of IPV and improving access to mental health services are critical steps in mitigating the long-term psychological burden on women worldwide.
Background Depressive disorder is a leading cause of disability, with significant increases among adolescents and young adults. Childhood sexual abuse (CSA) and bullying victimisation are major risk factors, yet their specific contribution remains underexplored. Aims To quantify the global burden of depressive disorder attributable to CSA and bullying victimisation among adolescents and young adults, examine temporal trends and project burden to 2050. Method Using Global Burden of Disease 2021 data, years lived with disability (YLD) for depressive disorder related to CSA and bullying victimisation were estimated across 204 countries and 21 regions. Age-standardised YLD rates (ASYR) were calculated, and joinpoint regression was used to assess average annual percentage changes. Bayesian age-period-cohort (BAPC) modelling projected future trends. Results In 2021, bullying victimisation accounted for a substantially larger proportion of depressive disorder burden (73.31%, ASYR: 87.83 out of 100 000) than CSA (11.81%, ASYR: 14.15 out of 100 000). Both risk factors increased from 1990 to 2021, with bullying victimisation rising faster, particularly in high sociodemographic index regions. Women experienced a substantially higher CSA-related burden (ASYR ratio 1.78:1), whereas men had a slightly higher bullying victimisation-related burden (ASYR ratio 1.02:1). Burden peaked among those aged 20–24 years for both risk factors. BAPC projections suggest that CSA-related depressive disorder will increase through to 2050, whereas bullying victimisation-related depressive disorder may decline, although uncertainty remains regarding future prevention efforts and reporting patterns. Conclusions ASYR for depressive disorder due to both CSA and bullying victimisation increased from 1990 to 2021; CSA-related burden is projected to continue rising through to 2050, whereas bullying victimisation-related burden may decline. Gender differences, age-specific peaks and regional disparities highlight the need for gender-sensitive, age-appropriate and region-specific interventions to address depressive disorder related to CSA and bullying victimisation.
