Severe mental illness (SMI) and victimization are intersectional as one preceded the other. This study estimated the prevalence rates of different forms of abuse and the multidimensional impact of abuse among persons with SMI. Eleven electronic databases were searched for studies published during 2010–2021. A total of 38 studies in English were included if full-text articles published in peer-reviewed journals; cross-sectional, cohort, and case–control studies; measuring abuse among males and females ≥16 years with psychiatric illness but excluded studies if focusing on populations such as prisoners or homeless, or individuals with substance abuse or intellectual developmental disorder; review articles, qualitative studies, case series, and experimental studies. A total of 76,499 participants with SMI were included in 28 (73.7%) cross-sectional studies, 3 (7.9%) case–control studies, and 7 (18.4%) cohort design studies. The prevalence of physical abuse ranged from 5% to 64% among men and 6–37.7% among women; sexual abuse ranged from 3% to 22.9% among men and from 2% to 62% among women; psychological abuse was 27% among men and women ranging from 39% to 83%; domestic violence ranged from 14.8% to 95.2% among men and from 10% to 67% among women, and criminal victimization ranged from 3.5% to 70% among the mixed psychiatric sample. The systematic review showed the following significant impact: poor clinical outcomes; physical injury; higher level of depression, anxiety, somatic symptoms, and self-harm tendencies among women, and substance abuse and aggressive behavior among men; role strain; parentification; social withdrawal and interpersonal difficulties. Psychiatric populations were at higher risk of victimization by multiple perpetrators at different points in time. Physical abuse was easily identified and reported largely; but sexual and emotional abuse present subtly, depends upon clinician skills, judgment, and confidence to explore and report. Often, victimization has a negative impact on physical and mental well-being, relationships, and community life.
Get full access to this article
View all access options for this article.
References
1.
AfeTO, EmedohTC, OgunsemiO, et al. (2016). Intimate partner violence, psychopathology and the women with schizophrenia in an outpatient clinic South-South, Nigeria. BMC Psychiatry. 16, 1–8.
2.
AfeTO, EmedohTC, OgunsemiOO, et al. (2017). Socio-demographic characteristics, partner characteristics, socioeconomic variables, and intimate partner violence in women with schizophrenia in South-South Nigeria. J Health Care Poor Underserved. 28, 707–720.
3.
AndersonF, HowardL, DeanK, et al. (2016). Childhood maltreatment and adulthood domestic and sexual violence victimization among people with severe mental illness. Soc Psychiatry Psychiatr Epidemiol. 51, 961–970.
4.
AxinnWG, GhimireDJ, WilliamsNE, et al. (2013). Gender, traumatic events, and mental health disorders in a rural Asian setting. J Health Soc Behav. 54, 444–461.
5.
Bengtsson-TopsA, TopsD. (2007). Self-reported consequences and needs for support associated with abuse in female users of psychiatric care. Int J Ment Health Nurs. 16, 35–43.
6.
BhatiaMS, SrivastavaS, KhyatiM, et al. (2016). Prevalence of abuse in mentally ill patients visiting outpatient setting in a tertiary care hospital in India. Med Sci Law. 56, 91–98.
7.
BhavsarV, DeanK, HatchSL, et al. (2019). Psychiatric symptoms and risk of victimization: A population-based study from Southeast London. Epidemiol Psychiatr Sci. 28, 168–178.
8.
BrekkeJS, PrindleC, BaeSW, et al. (2001). Risks for individuals with schizophrenia who are living in the community. Psychiatr Serv. 52, 1358–1366.
9.
BurgeSK. (1998). How do you define abuse?. Arch Fam Med. 7, 31–32.
10.
CasesJG, UsaolaCP, AguadoFG, et al. (2014). Prevalence and characteristics of intimate partner violence against women with severe mental illness: A prevalence study in Spain. Community Ment Health J. 50, 841–847.
11.
CanettoSS. (2019). Teaching about women and gender from a transnational and intersectional feminist perspective. Int Perspect Psychol. 8, 144–160.
12.
ChandraPS, CareyMP, CareyKB, et al. (2003). Sexual coercion and abuse among women with a severe mental illness in India: An exploratory investigation. Compr Psychiatry. 44, 205–212.
13.
ChangJC, ClussPA, BurkeJG, et al. (2011). Partner violence screening in mental health. Gen Hosp Psychiatry. 33, 58–65.
14.
ChapmanR, StylesI. (2006). An epidemic of abuse and violence: Nurse on the front line. Accid Emerg Nurs.14,245–249.
15.
ChoeJY, TeplinLA, AbramKM. (2008). Perpetration of violence, violent victimization, and severe mental illness: Balancing public health concerns. Psychiatr Serv. 59, 153–164.
16.
CokerAL, SmithPH, FaddenMK. (2005). Intimate partner violence and disabilities among women attending family practice clinics. J Women's Health. 14, 829–838.
17.
CrisantiAS, FruehBC, ArchambeauO, et al. (2014). Prevalence and correlates of criminal victimization among new admissions to outpatient mental health services in Hawaii. Community Ment Health J. 50, 296–304.
18.
de MooijLD, KikkertM, LommerseNM, et al. (2015). Victimisation in adults with severe mental illness: Prevalence and risk factors. Br J Psychiatry. 207, 515–522.
19.
de VriesB, van BusschbachJT, van der StouweEC, et al. (2019a). Prevalence rate and risk factors of victimization in adult patients with a psychotic disorder: A systematic review and meta-analysis. Schizophr Bull. 45, 114–126.
20.
de VriesB, PijnenborgGH, van der StouweEC, et al. (2019b). Pharmaco therapy and outcome survey (PHAMOUS)-investigators, … & van Busschbach, JT. “Please tell me what happened”: A descriptive study on prevalence, disclosure and characteristics of victimization in people with a psychotic disorder. PLoS One, 14, e0219056.
21.
de OliveiraHN, MachadoCJ, GuimarãesMDC. (2012). Factors associated with self-report of sexual violence against men and women with mental disorders in Brazil. Soc Psychiatry Psychiatr Epidemiol. 47, 1567–1579.
22.
DevriesKM, MakJY, BacchusLJ, et al. (2013). Intimate partner violence and incident depressive symptoms and suicide attempts: A systematic review of longitudinal studies. PLoS Med. 10, e1001439.
23.
El MissiryA, MeguidMAE, AbourayahA, et al. (2019). Rates and profile of victimization in a sample of Egyptian patients with major mental illness. Int J Soc Psychiatry. 65, 183–193.
24.
EvansM, GregoryA, FederG, et al. (2016). “Even ‘daily’ is not enough”: How well do we measure domestic violence and abuse?. A think-aloud study of a commonly used self-report scale. Violence Vict. 31, 3–26.
25.
FekryM, BassimRE, abd El MaguidM, et al. (2012). Clinical and psychodemographic profile of victimized versus nonvictimized Egyptian patients with bipolar mood disorder. Middle East Curr Psychiatry. 19, 131–141.
26.
FortugnoF, KatsakouC, BremnerS, et al. (2013). Symptoms associated with victimization in patients with schizophrenia and related disorders. PLoS One. 8, e58142.
27.
GatovE, KozielN, KurdyakP, et al. (2020). Discharge and post-discharge outcomes of psychiatric in-patients with a lifetime history of exposure to interpersonal trauma: A population-based study. Gen Hosp Psychiatry. 65, 82–90.
28.
HarrisMN, BaumannML, TeasdaleB, et al. (2020). Estimating the relationship between perceived stigma and victimization of people with mental illness. J Interpers Violence. 37, NP1226–NP1252.
29.
HartC, de VetR, MoranP, et al. (2012). UK population-based study of the relationship between mental disorder and victimisation. Soc Psychiatry Psychiatr Epidemiol. 47, 1581–1590.
30.
HidayVA, SwansonJW, SwartzMS, et al. (2001). Victimization: A link between mental illness and violence?. Int J Law Psychiatry. 24, 559–572.
31.
HowardLM, TrevillionK, KhalifehH, et al. (2010). Domestic violence and severe psychiatric disorders: Prevalence and interventions. Psychol Med,, 40, 881–889.
32.
HughesK, BellisMA, JonesL, et al. (2012). Prevalence and risk of violence against adults with disabilities: A systematic review and meta-analysis of observational studies. Lancet. 379, 1621–1629.
33.
KarakocB, GülserenL, Birmay ÇAM, et al. (2015). Prevalence of intimate partner violence and associated factors. Nöro Psikiyatri Arşivi. 52, 324–330.
34.
KatsikidouM, SamakouriM, FotiadouM, et al. (2013). Victimization of the severely mentally ill in Greece: The extent of the problem. Int J Soc Psychiatry. 59, 706–715.
35.
KhalifehH, JohnsonS, HowardLM, et al. (2015a). Violent and non-violent crime against adults with severe mental illness. Br J Psychiatry. 206, 275–282.
36.
KhalifehH, MoranP, BorschmannR, et al. (2015b). Domestic and sexual violence against patients with severe mental illness. Psychol Med., 45, 875–886.
37.
KhalifehH, OramS, OsbornD, et al. (2016). Recent physical and sexual violence against adults with severe mental illness: A systematic review and meta-analysis. Int Rev Psychiatry. 28, 433–451.
38.
KingTL, ShieldsM, ShakespeareT, et al. (2019). An intersectional approach to understandings of mental health inequalities among men with disability. SSM Popul Health. 9, 100464.
39.
LatalovaK, KamaradovaD, PraskoJ. (2014). Violent victimization of adult patients with severe mental illness: A systematic review. Neuropsychiatr Dis Treat. 10, 1925–1939.
40.
LoughlandCM, LawrenceG, AllenJ, et al. (2009). Aggression and trauma experiences among carer-relatives of people with psychosis. Soc Psychiatry Psychiatr Epidemiol. 44, 1031–1040.
41.
ManiglioR. (2009). Severe mental illness and criminal victimization: A systematic review. Acta Psychiatr Scand. 119, 180–191.
42.
MeijwaardSC, KikkertM, de MooijLD, et al. (2015). Risk of criminal victimisation in outpatients with common mental health disorders. PLoS One. 10, e0128508.
43.
MeyersfeldBC. (2012). The Council of Europe Convention on Preventing and Combating Violence Against Women and Domestic Violence: Council of Europe Convention on Preventing and Combating Violence Against Women and Domestic Violence. Int Leg Mater. 51, 106–132.
44.
MoherD, LiberatiA, TetzlaffJ, et al. (2009). Prisma Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med. e151,264–269.
45.
MonahanJ, VesselinovR, RobbinsPC, et al. (2017). Violence to others, violent self-victimization, and violent victimization by others among persons with a mental illness. Psychiatr Serv. 68, 516–519.
46.
MowldsW, ShannonC, McCuskerCG, et al. (2010). Autobiographical memory specificity, depression, and trauma in bipolar disorder. Br J Clin Psychol. 49, 217–233.
47.
MuenzenmaierK, SchneebergerAR, CastilleDM, et al. (2014). Stressful childhood experiences and clinical outcomes in people with serious mental illness: A gender comparison in a clinical psychiatric sample. J Fam Violence. 29, 419–429.
48.
NewmanJM, TurnbullA, BermanBA, et al. (2010). Impact of traumatic and violent victimization experiences in individuals with schizophrenia and schizoaffective disorder. J NervMent Dis. 198, 708–714.
49.
NyameS, HowardLM, FederG, et al. (2013). A survey of mental health professionals' knowledge, attitudes and preparedness to respond to domestic violence. J Ment Health. 22, 536–543.
OramS, TrevillionK, FederG, et al. (2013). Prevalence of experiences of domestic violence among psychiatric patients: Systematic review. Br J Psychiatry. 202, 94–99.
52.
OrchowskiLM, GidyczCA. (2012). To whom do college women confide following sexual assault?. A prospective study of predictors of sexual assault disclosure and social reactions. Violence Against Women.18,264–288.
53.
PenceE, PaymarM, RitmeesterT. (1993). Education Groups for Men Who Batter: The Duluth Model. (Springer Publishing Company, New York, NY).
54.
PettittB, GreenheadS, KhalifehH, et al. (2013). At Risk, Yet Dismissed: The Criminal Victimisation of People with Mental Health Problems. (Victim Support and Mind, London), pp. 80–83.
55.
Rakovec-FelserZ. (2014). Domestic violence and abuse in intimate relationship from public health perspective. Health Psychol Res. 2, 1821.
56.
RamD. (2017). Levels of abuse in mentally ill women and its relationship with health care behavior-An exploratory study. J Psychopathol. 23, 52–59.
57.
RoseD, TrevillionK, WoodallA, et al. (2011). Barriers and facilitators of disclosures of domestic violence by mental health service users: Qualitative study. Br J Psychiatry. 198, 189–194.
58.
ShahR, Von MachT, FedinaL, et al. (2018). Intimate partner violence and psychotic experiences in four US cities. Schizophr Res. 195, 506–512.
59.
ShannonC, MaguireC, AndersonJ, et al. (2011). Enquiring about traumatic experiences in bipolar disorder: A case note and self-report comparison. J Affect Disord. 133, 352–355.
60.
ShortTB, ThomasS, LuebbersS, et al. (2013). A case-linkage study of crime victimisation in schizophrenia-spectrum disorders over a period of deinstitutionalisation. BMC Psychiatry. 13, 1–9.
61.
SilverE, PiqueroAR, JenningsWG, (2011). Assessing the violent offending and violent victimization overlap among discharged psychiatric patients. Law Hum Behav. 35, 49–59.
62.
SturupJ, SormanK, LindqvistP, et al. (2011). Violent victimisation of psychiatric patients: A Swedish case–control study. Soc Psychiatry Psychiatr Epidemiol. 46, 29–34.
63.
SwansonJW, SwartzMS, EssockSM, et al. (2002). The social–environmental context of violent behavior in persons treated for severe mental illness. Am J Public Health. 92, 1523–1531.
64.
SwartzMS, BhattacharyaS. (2017). Victimization of persons with severe mental illness: A pressing global health problem. World Psychiatry. 16, 26–27.
65.
Tasa-VinyalsE, ÁlvarezMJ, Puigoriol-JuvantenyE, et al. (2020). Intimate partner violence among patients diagnosed with severe mental disorder. J Nerv Ment Dis. 208, 749–754.
66.
TeasdaleB, DaigleLE, BallardE. (2014). Trajectories of recurring victimization among people with major mental disorders. J Interpers Violence. 29, 987–1005.
67.
TomlinsonB. (2013). To tell the truth and not get trapped: Desire, distance, and intersectionality at the scene of argument. Signs. 38, 993–1017.
68.
TraniJF, BakhshiP, KuhlbergJ, et al. (2015). Mental illness, poverty and stigma in India: A case–control study. BMJ Open. 5, e006355.
69.
TsigebrhanR, ShibreT, MedhinG, et al. (2014). Violence and violent victimization in people with severe mental illness in a rural low-income country setting: A comparative cross-sectional community study. Schizophr Res. 152, 275–282.
70.
TuranJM, ElafrosMA, LogieCH, et al. (2019). Challenges and opportunities in examining and addressing intersectional stigma and health. BMC Med. 17, 1–5.
71.
UmbersonD, Thomeer MiekeB, WilliamsK. (2012). Family Status and Mental Health: Recent Advances and Future Directions. In: Handbook of the Sociology of Mental Health. CS Aneshensel, JC Phelan, A Bierman, eds. (Springer, New York), pp. 405–431.
72.
VandenbrouckelJP, von ElmE, AltmanDG, et al. (2007). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and elaboration. PLoS Med. 4, 1628–1655.
73.
WalkerLE. (1999). Psychology and domestic violence around the world. Am Psychol. 54, 21–29.
74.
WalshE, MoranP, ScottC, et al. (2003). Prevalence of violent victimisation in severe mental illness. Br J Psychiatry. 183, 233–238.
75.
WangQW, HouCL, WangSB, et al. (2020). Frequency and correlates of violence against patients with schizophrenia living in rural China. BMC Psychiatry. 20, 1–8.
76.
WellsA, SheaB, O'ConnellD, et al. (2016). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. www.ohri. ca/programs/clinical_epidemiology/oxford.asp (accessed June9, 2021).
77.
WhiteheadNL. (2004). On the poetics of violence. In Violence. WhiteheadNL, ed. (School of American research Press, Santa Fe, NM), pp. 55–77.
78.
WillieTC, OlavarrietaCD, ScoleseA, et al. (2020). Intimate partner violence and reproductive coercion against a clinic-based sample of low-income women in Mexico City: A latent class analysis. Int J Obstet Gynaecol. 150, 412–414.
79.
YildirimMH, YildirimEA, KaserM, et al. (2014). The relationship between adulthood traumatic experiences and psychotic symptoms in female patients with schizophrenia. Compr Psychiatry. 55, 1847–1854.
80.
ZarchevM, MulderCL, HenrichsJ, et al. (2021). Victimisation of individuals with serious mental illness living in sheltered housing: Differential impact of risk factors related to clinical and demographic characteristics. Br J Psych Open. 7, 1–7.
81.
ZarchevM, RuijneRE, MulderCL, et al. (2022). Prevalence of adult sexual abuse in men with mental illness: Bayesian meta-analysis. Br J Psych Open, 8, e16.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
