Mental health issues in survivors of domestic violence during the COVID-19 pandemic: A multicentric cross-sectional study from India

Abstract

Objective: Frequency, intensity, and manifestations of domestic violence during COVID remain undetermined in a large country like India. The study aimed to determine the mental health and coping mechanisms of women facing domestic violence during the COVID-19 pandemic. Methods: A World Health Organization-funded, multicentric, cross-sectional analytical study was undertaken in rural and urban health centers of seven institutions spanning major regions of India. Mental health was assessed using the Depression Anxiety Stress Scale (DASS). The Impact of Event Scale—Revised (IES-R) was used to assess post-traumatic stress disorder (PTSD) symptoms, the Kansas Marital Satisfaction Scale (KMSS) was used to measure marital quality, and the Brief COPE inventory scale was used to assess coping responses upon reaction to specific stressors. Results: Women faced different types of domestic violence, with 70.7% reporting physical, 33.7% sexual, 74.9% emotional, and 74.4% financial violence. Common physical symptoms included headache (63.6%) and sleep disturbances (49.1%), while psychological symptoms included unhappiness (66.9%) and tiredness (62.8%). Overall, 57.6% of women exhibited psychological distress based on the DASS. Extremely severe anxiety and depression were reported in 29.2% and 23.6%, respectively. PTSD was detected in 7.9% using the IES-R, and 40.3% had extreme PTSD symptoms. Physical, sexual, and emotional violence were associated with heightened stress, anxiety, and depression (P < 0.001). Coping assessments revealed a highly avoidant (27.9%), problem-focused (27.6%), and emotion-focused (30.6%) coping styles. Emotional and sexual violence were significantly associated with a highly avoidant and emotion-focused coping (P < 0.001). Conclusions: Domestic violence was frequent during the COVID-19 pandemic and was associated with several somatic symptoms, stress, anxiety, and depression. Preventive measures and early intervention are crucial to decrease the incidence of violence.