Domestic violence in the Emergency Department: I. Two case-control studies of victims.

The object of this study was to compare the diagnoses and characteristics of self-reported domestic violence victims with a random sample of nonvictim controls who were selected from attendees at the Emergency Department (ED) of a major public hospital in Australia. Comparisons were made at index presentation and for the 5 years prior to index presentation. Subjects were drawn from two screening studies carried out 1 year apart which were conducted to assess the prevalence of domestic violence among attendees at the ED. From these groups, the medical records of all individuals who had disclosed domestic violence were examined and compared with the medical records of a random sample of nondisclosers, matched for age (+/- 10 years), sex, and type of entry into the ED (acute vs nonacute). The two case-control studies, conducted 12 months apart, showed that there were statistically significant differences between the diagnoses and characteristics of victims and nonvictims. Victims made more visits to the ED and Outpatients' Department than nonvictims; victims had more psychiatric index presentations; more victims had evidence of treatment of psychiatric conditions, both as inpatients and outpatients, in the previous 5 years than nonvictims; victims had greater rates of attempted suicide and alcohol problems than nonvictims at index presentation and for the previous 5 years. The findings indicate the need for the prevention and treatment of psychiatric conditions of domestic violence victims, including drug and alcohol problems and suicidal ideation. The findings form the basis of hypotheses for further studies to investigate the association between domestic violence and psychiatric illness.