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. 2025 Jan-Dec:21:17455057251351410.
doi: 10.1177/17455057251351410. Epub 2025 Jul 6.

Association between intimate partner violence and depressive symptoms across household wealth levels in women of reproductive age in Peru

José A Chaquila  1 , Helena Cabada-Yépez  1 , Fresia Miranda-Torvisco  1 , Gianella Ramirez-Jeri  1
Affiliations

Association between intimate partner violence and depressive symptoms across household wealth levels in women of reproductive age in Peru

José A Chaquila et al. Womens Health (Lond). 2025 Jan-Dec.

Abstract

Background: Intimate partner violence (IPV) is the most prevalent form of violence against women globally and is linked to depressive symptoms and other mental health disorders. Socioeconomic status is associated with both IPV and depressive symptoms, yet few studies have explored household wealth as a potential modifier of this relationship.

Objectives: To analyze the association between IPV and depressive symptoms according to household wealth levels among Peruvian women in 2023.

Design: Cross-sectional study.

Methods: A secondary analysis of the 2023 Demographic and Family Health Survey (ENDES) in Peru was conducted, including 10,161 women of reproductive age in the final analysis. The exposure variable was IPV, and the outcome variable was depressive symptoms. Household wealth levels were classified into quintiles ranging from Q1 (poorest) to Q5 (wealthiest). A multivariate regression analysis was performed.

Results: The association between IPV and depressive symptoms decreased as household wealth increased: poorest (adjusted prevalence ratio (aPR): 2.42, 95% confidence interval (CI): 2.07-2.83), poor (aPR: 2.02, 95% CI: 1.64-2.5), and middle-income (aPR: 1.89, 95% CI: 1.47-2.43); however, no associations were found in wealthy households (aPR: 1.37, 95% CI: 0.96-1.94). In the wealthiest households, the association between IPV and depressive symptoms was significant again (aPR: 2.71, 95% CI: 1.69-4.34). Emotional and physical violence showed similar trends in relation to household wealth levels. In wealthy households, no type of IPV (emotional, sexual, or physical) was associated with depressive symptoms.

Conclusion: We found that the association between IPV and depressive symptoms is unequal and not present at all household wealth levels in Peru. A moderate level of wealth may weaken the association between IPV and depressive symptoms among Peruvian women of reproductive age. Moreover, in the wealthiest households, the association is even stronger than in poorer households, which has implications for the implementation of universal and inclusive public policies that address women and families across all socioeconomic sectors.

Keywords: depression symptoms; gender-based violence; intimate partner violence; wealth index.

Plain language summary

This study aimed to understand how intimate partner violence (IPV) is related to depressive symptoms in more than 10,000 Peruvian women aged 15–49 years in five different socioeconomic levels, as measured by the wealth of the woman’s household. We found that this relationship is unequal, and even absent at a certain level of wealth, as in women from moderately wealthy households. Contrary to expectations, women from wealthiest households who experience IPV appear to be more susceptible to depressive symptoms than their counterparts from poor households. These results highlight that women from wealthiest households are not immune to developing depression in the future due to violence experienced from their partner. These findings aim to inform the design of policies and programs that better protect all women and their families, regardless of their economic status.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Flowchart shows selection process from 18,486 women evaluated in 2023 to effective 10,161 sampled women analyzed in studies.
Figure 1.
Flowchart for sample selection.
Depicting trends in IPV and depressive symptoms across different wealth brackets.
Figure 2.
Prevalence of types of violence, IPV and depressive symptoms according to household wealth level. IPV: Intimate partner violence; CI: confidence interval.
The graphs present the association between IPV, physical, emotional and sexual violence with depressive symptoms categorized by household wealth. The analysis is adjusted for age, marital status, number of children, education, marital violence, partner's education, partner's age, alcohol consumption, and residence.
Figure 3.
Association between IPV, physical, emotional and sexual violence with depressive symptoms according to household wealth. The graphs show only the PR adjusted for age, marital status, number of children, education, interparental violence, partner’s education, partner’s age, partner’s alcohol consumption, and residence. a) IPV associated with depressive symptoms; b) sexual violence associated with depressive symptoms; c) physical violence associated with depressive symptoms; d) emotional violence associated with depressive symptoms. IPV: intimate partner violence; aPR: adjusted prevalence ratio.
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