Psychotropic medication use and intimate partner violence at 4 years postpartum: Results from an Australian pregnancy cohort study

Abstract

Background: In the perinatal period, maternal mental health problems and intimate partner violence often co-occur. We aimed to examine associations between psychotropic medication use and intimate partner violence (IPV) in an Australian population-based sample.

Methods: Prospective cohort study of 1507 first-time mothers recruited in early pregnancy (mean gestation 15 weeks) from public maternity hospitals in Melbourne Australia. Follow-up questionnaires at 12 months and four years included validated measures of intimate partner violence (Composite Abuse Scale), and maternal mental health (Edinburgh Postnatal Depression Scale, SF-36). Data on use of psychotropic medications was collected using a self-report measure at four years postpartum.

Results: At four years postpartum, almost one in eight mothers (13.9%) were taking psychotropic medication. The prevalence of psychotropic medication use in women experiencing concurrent IPV was considerably higher compared to women not experiencing IPV (25% vs 11%, Odds Ratio = 2.68, 95% CI 1.73-4.15). Women experiencing IPV were significantly more likely to be taking psychotropic medication, even after adjusting for sociodemographic factors and depressive symptoms (Adj OR = 1.86, 95% CI 1.16 to 2.96). Only 5% of women reporting IPV at four years postpartum had discussed this with a general practitioner.

Limitations: Limitations include use of a self-report measure to assess psychotropic medication use, lack of data on the use of psychological counselling and/or other specialist mental health services and potential for attrition to bias results (addressed using multiple imputation).

Conclusions: Our findings reinforce the need for health professionals treating women for depressive symptoms to inquire about IPV and tailor responses accordingly.

Keywords: Cohort study; Intimate partner violence; Maternal anxiety; Maternal depression; Psychotropic medication.