Correspondence
mental health professionals generally have little training on intimate partner violence and feel poorly equipped.5 Could primary care assist with early intervention? Primary care interventions for women are effective at increasing identification, referrals, and safety discussion, and at decreasing depressive symptoms.6 WHO guidelines support the key role of primary care in the first-line response, especially in countries with no specialised services. The life-course approach to women’s mental health should be applauded; however, we suggest that including intimate partner violence and other forms of gender-based violence in the model might show the key role of abuse in development of later depressive symptoms.7 Early mental health interventions with young women should address intimate partner violence. We declare no competing interests.
*Kelsey L Hegarty, Laura Tarzia [email protected] Department of General Practice, University of Melbourne, Melbourne, VIC, Australia (KLH, LT) 1
2
3
4
5
6 Published Online December 18, 2015 http://dx.doi.org/10.1016/ S0140-6736(15)01305-7
7
126
Patton GC, Romaniuk H, Spry E, et al. Prediction of preinatal depression from adolescence and before conception (VIHCS): 20-year prospective cohort study. Lancet 2015; 386: 875–83. Rees S, Silove D, Chey T, et al. Lifetime prevalence of gender-based violence in women and the relationship with mental disorders and psychosocial function. JAMA 2011; 306: 513–21. Devries KM, Mak J, Bacchus LJ, et al. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med 2013; 10: e1001439. Taft A, Watson LF. Depression and termination of pregnancy (induced abortion) in a national cohort of young Australian women: the confounding effect of women’s experience of violence. BMC Public Health 2008; 8: 75. Nyame S, Howard LM, Feder G, Trevillion K. A survey of mental health professionals’ knowledge, attitudes and preparedness to respond to domestic violence. J Mental Health 2013; 22: 536–43. Hegarty K, O’Doherty L, Taft A, et al. Screening and counselling in the primary care setting for women who have experienced intimate partner violence (WEAVE): a cluster randomised controlled trial. Lancet 2013; 382: 249–58. Woolhouse H, Gartland D, Mensah FK, Brown S. Maternal depression from early pregnancy to four years postpartum in a prospective pregnancy cohort study: implications for primary health care. BJOG 2014; 122: 312–21.
Authors’ reply Kelsey Hegarty and Laura Tarzia comment on the role of intimate partner violence in depression in young women and the scope for intervention through primary care. There is little doubt that the origins of common mental disorders, including depression, lie in an individual’s social and relational context. Intimate partner violence is common in developed and developing countries, and is linked to depression and other mental disorders in young women.1,2 Risks also arise from other aspects of social context during adolescence and young adulthood, including bullying, sexual violence, family conflict, emotional deprivation, and physical and sexual abuse. 3,4 These factors affect recurrence and persistence of common mental disorders in the perinatal period.5 Our Article6 focused on the lifecourse of depressive symptoms from adolescence through to the perinatal period in one of the few available cohorts. Although the majority of those with high depressive symptoms had a history of similar problems before conception, most women with a previous history did not go on to experience perinatal depressive symptoms.6 A woman’s relationship with her intimate partner, including experiences of physical and emotional abuse, is likely to be a major determinant of any persistence or recurrence,5,7 and we agree with Hegarty and Tarzia that primary care is an essential setting for screening and intervention for the women at highest risk.
(CO); Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia (CO); and Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, and General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, VIC, Australia (SB) 1
2
3
4
5
6
7
Devries KM, Mak JY, Bacchus LJ, et al. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med 2013; 10: e1001439. Fulu E, Jewkes R, Roselli T, Garcia-Moreno C. Prevalence of and factors associated with male perpetration of intimate partner violence: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific. Lancet Glob Health 2013; 1: e187–207. Gladstone GL, Parker GB, Mitchell PB, Malhi GS, Wilhelm K, Austin M-P. Implications of childhood trauma for depressed women: an analysis of pathways from childhood sexual abuse to deliberate self-harm and revictimization. Am J Psych 2004; 161: 1417–25. Patton GC, Olsson C, Bond L, et al. Predicting female depression across puberty: a twonation longitudinal study. J Am Acad Child Adolesc Psychiatry 2008; 47: 1424–32. Howard LM, Molyneaux E, Dennis C-L, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Lancet 2014; 384: 1775–88. Patton GC, Romaniuk H, Spry E, et al. Prediction of perinatal depression from adolescence and before conception (VIHCS): 20-year prospective cohort study. Lancet 2015; 386: 875–83. Brown SJ, McDonald EA, Krastev AH. Fear of an intimate partner and women’s health in early pregnancy: findings from the Maternal Health Study. Birth 2008; 35: 293–302.
We declare no competing interests.
*George C Patton, Craig Olsson, Stephanie Brown, on behalf of the study authors [email protected] Centre for Adolescent Health, Murdoch Childrens Research Institute, University of Melbourne, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia (GCP); Psychological Sciences and Paediatrics, Murdoch Childrens Research Institute, University of Melbourne, Parkville, VIC, Australia
Department of Error Palmer J, Mullan Z. Highlights 2015: pictures of health. Lancet 2015; 386: 2463—The second sentence of the second paragraph should read: “Tobacco advertising is the focus of two pictures: Matthieu Zellweger and Johanna Dollerson show us strong action against illegal tobacco advertisements in Bangladesh…”. This correction has been made to the online version as of Dec 18, 2015.
www.thelancet.com Vol 387 January 9, 2016
mental health professionals generally have little training on intimate partner violence and feel poorly equipped.5 Could primary care assist with early intervention? Primary care interventions for women are effective at increasing identification, referrals, and safety discussion, and at decreasing depressive symptoms.6 WHO guidelines support the key role of primary care in the first-line response, especially in countries with no specialised services. The life-course approach to women’s mental health should be applauded; however, we suggest that including intimate partner violence and other forms of gender-based violence in the model might show the key role of abuse in development of later depressive symptoms.7 Early mental health interventions with young women should address intimate partner violence. We declare no competing interests.
*Kelsey L Hegarty, Laura Tarzia [email protected] Department of General Practice, University of Melbourne, Melbourne, VIC, Australia (KLH, LT) 1
2
3
4
5
6 Published Online December 18, 2015 http://dx.doi.org/10.1016/ S0140-6736(15)01305-7
7
126
Patton GC, Romaniuk H, Spry E, et al. Prediction of preinatal depression from adolescence and before conception (VIHCS): 20-year prospective cohort study. Lancet 2015; 386: 875–83. Rees S, Silove D, Chey T, et al. Lifetime prevalence of gender-based violence in women and the relationship with mental disorders and psychosocial function. JAMA 2011; 306: 513–21. Devries KM, Mak J, Bacchus LJ, et al. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med 2013; 10: e1001439. Taft A, Watson LF. Depression and termination of pregnancy (induced abortion) in a national cohort of young Australian women: the confounding effect of women’s experience of violence. BMC Public Health 2008; 8: 75. Nyame S, Howard LM, Feder G, Trevillion K. A survey of mental health professionals’ knowledge, attitudes and preparedness to respond to domestic violence. J Mental Health 2013; 22: 536–43. Hegarty K, O’Doherty L, Taft A, et al. Screening and counselling in the primary care setting for women who have experienced intimate partner violence (WEAVE): a cluster randomised controlled trial. Lancet 2013; 382: 249–58. Woolhouse H, Gartland D, Mensah FK, Brown S. Maternal depression from early pregnancy to four years postpartum in a prospective pregnancy cohort study: implications for primary health care. BJOG 2014; 122: 312–21.
Authors’ reply Kelsey Hegarty and Laura Tarzia comment on the role of intimate partner violence in depression in young women and the scope for intervention through primary care. There is little doubt that the origins of common mental disorders, including depression, lie in an individual’s social and relational context. Intimate partner violence is common in developed and developing countries, and is linked to depression and other mental disorders in young women.1,2 Risks also arise from other aspects of social context during adolescence and young adulthood, including bullying, sexual violence, family conflict, emotional deprivation, and physical and sexual abuse. 3,4 These factors affect recurrence and persistence of common mental disorders in the perinatal period.5 Our Article6 focused on the lifecourse of depressive symptoms from adolescence through to the perinatal period in one of the few available cohorts. Although the majority of those with high depressive symptoms had a history of similar problems before conception, most women with a previous history did not go on to experience perinatal depressive symptoms.6 A woman’s relationship with her intimate partner, including experiences of physical and emotional abuse, is likely to be a major determinant of any persistence or recurrence,5,7 and we agree with Hegarty and Tarzia that primary care is an essential setting for screening and intervention for the women at highest risk.
(CO); Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, Australia (CO); and Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, and General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, VIC, Australia (SB) 1
2
3
4
5
6
7
Devries KM, Mak JY, Bacchus LJ, et al. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med 2013; 10: e1001439. Fulu E, Jewkes R, Roselli T, Garcia-Moreno C. Prevalence of and factors associated with male perpetration of intimate partner violence: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific. Lancet Glob Health 2013; 1: e187–207. Gladstone GL, Parker GB, Mitchell PB, Malhi GS, Wilhelm K, Austin M-P. Implications of childhood trauma for depressed women: an analysis of pathways from childhood sexual abuse to deliberate self-harm and revictimization. Am J Psych 2004; 161: 1417–25. Patton GC, Olsson C, Bond L, et al. Predicting female depression across puberty: a twonation longitudinal study. J Am Acad Child Adolesc Psychiatry 2008; 47: 1424–32. Howard LM, Molyneaux E, Dennis C-L, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. Lancet 2014; 384: 1775–88. Patton GC, Romaniuk H, Spry E, et al. Prediction of perinatal depression from adolescence and before conception (VIHCS): 20-year prospective cohort study. Lancet 2015; 386: 875–83. Brown SJ, McDonald EA, Krastev AH. Fear of an intimate partner and women’s health in early pregnancy: findings from the Maternal Health Study. Birth 2008; 35: 293–302.
We declare no competing interests.
*George C Patton, Craig Olsson, Stephanie Brown, on behalf of the study authors [email protected] Centre for Adolescent Health, Murdoch Childrens Research Institute, University of Melbourne, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia (GCP); Psychological Sciences and Paediatrics, Murdoch Childrens Research Institute, University of Melbourne, Parkville, VIC, Australia
Department of Error Palmer J, Mullan Z. Highlights 2015: pictures of health. Lancet 2015; 386: 2463—The second sentence of the second paragraph should read: “Tobacco advertising is the focus of two pictures: Matthieu Zellweger and Johanna Dollerson show us strong action against illegal tobacco advertisements in Bangladesh…”. This correction has been made to the online version as of Dec 18, 2015.
www.thelancet.com Vol 387 January 9, 2016
