Deleterious impact of intimate partner violence on health: A call to action

Abstract

In this editorial, I comment on the article by Yeh et al published in the recent issue of the World Journal of Psychiatry. Intimate partner violence (IPV) represents a pervasive societal problem with profound ramifications for both physical and psychological well-being. IPV represents a pervasive societal problem with profound ramifications for both physical and psychological well-being. Exposure to IPV is associated with a range of adverse physical health outcomes, including but not limited to injuries, chronic pain conditions, and compromised immune function. Furthermore, the psychological sequelae of IPV can be equally devastating, frequently manifesting as depression, anxiety, post-traumatic stress disorder, and diminished self-esteem. A primary driver is the imbalance of power and control within a relationship, where one partner seeks to dominate the other through coercion, intimidation, or physical force. Additionally, factors such as socioeconomic stress, substance abuse, and exposure to violence in childhood can increase the likelihood of perpetrating or experiencing IPV. Cultural norms that condone or normalize violence against individuals further contribute to its prevalence, perpetuating a cycle of abuse and harm. The insidious nature of IPV necessitates a comprehensive public health approach encompassing prevention, intervention, and ongoing support for affected individuals. Educational programs in schools and communities can promote healthy relationship skills, conflict resolution, and respectful communication. Public awareness campaigns play a crucial role in shifting societal attitudes and increasing understanding of IPV as a serious public health problem, ultimately fostering a culture of zero tolerance.

Key Words: Intimate partner violence; Health outcomes; Mental health; Public health; Prevention

Core Tip: This paper which focus on a multifaced public health crisis highlights how intimate partner violence not only causes immediate injuries and chronic health problems but also fuels depression, anxiety, post-traumatic stress disorder, and diminished self-esteem, creating a cycle of vulnerability that undermines long-term well-being. A core message is that addressing intimate partner violence requires an integrated strategy: Robust prevention that reshapes norms and power dynamics; timely, survivor-centered intervention, and access to supportive services; sustained public health investment to monitor outcomes, reduce risk factors (such as socioeconomic stress and childhood exposure to violence), and promote healthy, respectful relationships through education and community engagement.

This editorial refers to “Mental and physical health outcomes among IPV survivors in Taiwan: A nationwide registry-based case control study” by Yeh et al, 2026; https://doi.org/10.5498/wjp.v16.i1.112745.

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INTRODUCTION

Intimate partner violence (IPV) is a critical public health crisis that affects the well-being and quality of life for both individuals and communities[1]. This pervasive form of violence systematically undermines both physical and psychological health, resulting in direct injuries, chronic conditions, and profound mental health challenges, including depression, anxiety, and post-traumatic stress disorder[2]. IPV is rooted in power imbalances and perpetuated by socioeconomic stressors and cultural norms, and the need for multifaceted intervention strategies is urgent. IPV is a global crisis that affects millions through physical injuries, deep emotional trauma and social challenges. IPV causes physical injuries, chronic pain conditions, mental health disorders, and in extreme circumstances lead to death[3]. The effects of IPV spread throughout families and communities, resulting in decreased work productivity, increased healthcare costs, and exacerbated social strains[4]. Children who witness or experience IPV are at a greater risk of perpetuating or becoming victims of violence themselves, reinforcing an intergenerational cycle. IPV is a violation of fundamental human rights: The right to live freely, with dignity, and to pursue a fulfilling life. When individuals cannot live safely in their own homes, it undermines social progress, gender equality, and healthy family structures.

The global incidence rate of IPV is significant. Approximately one in three women worldwide will experience physical or sexual violence by an intimate partner in their lifetime[5]. Moreover, one in three women worldwide report having endured physical or sexual IPV[6]. In Organisation for Economic Co-operation and Development countries, approximately 22% of women report experiences of IPV. The highest rates of lifetime IPV are reported in southern Asia (35%) and sub-Saharan Africa (33%)[7]. In 2018, 13% of women who experienced IPV within the previous 12 months[8,9]. In Brazil, Peru, and Thailand, more than 15% of women reported experiencing IPV at least five times throughout their lifetime, indicating repeated, long-term exposure for a substantial minority[10]. Complementary data from a study of married couples in the United States reveal different patterns of partner violence: Approximately 8% of couples reported reciprocal mutual violence, approximately 4% of couples reported violence perpetrated only by the male partner, and nearly 2% of couples reported violence perpetrated only by the female partner[11]. Collectively, these findings highlight two findings that are important for guiding policy and research. First, many survivors experience repeated victimization; second, patterns of perpetration often involve reciprocity rather than unidirectional violence. These differences argue for measurement that captures frequency, severity, and mutuality and for interventions and services that are trauma informed and gender sensitive while addressing the different prevention and support needs that arise from chronic and reciprocal forms of IPV.

Some studies have reported that the prevalence of sexual violence by intimate partners during the coronavirus disease 2019 pandemic was approximately 14% among women[5]. Although men do experience IPV, global rates are generally lower for men than for women. Studies indicate that lifetime prevalence for men varies widely, with estimates ranging from approximately 7.8% to 19.3%, and in some cases, emotional violence may be particularly high[5,9]. One international study found that roughly one in thirteen men reported experiencing violence from an intimate partner, compared to one in four women[9]. In certain populations, up to 21.7% of men reported being a victim of domestic abuse in their lifetime[12]. While physical and sexual violence rates for men tend to be lower than for women, emotional and psychological forms of abuse are also significant and often underreported due to stigma and social expectations[13].

Furthermore, race and socioeconomic status shape the risk and experience of IPV in ways that reflect deep-seated social and structural inequalities. Racialized communities often face disproportionate exposure to IPV due to factors such as discrimination, neighborhood disadvantage, and differential access to resources, which can limit opportunities for protection, legal recourse, and supportive services[14]. Socioeconomic status influences IPV risk through pathways like economic dependence, housing instability, job insecurity, and unequal access to healthcare and mental health support[15]. Together, race and socioeconomic status interact to compound vulnerability, influence help-seeking behaviors, and affect the availability and effectiveness of interventions. Disability can also compound vulnerability by limiting mobility, communication, and independence, as well as creating dependence on abusive partners or caregivers and barriers to reporting violence or obtaining accommodations[16].

By framing IPV as preventable and solvable through coordinated policy, practice, and culturally sensitive interventions, the paper calls for concrete actions that advance zero tolerance, protect affected individuals, and strengthen population health. Based on this information my study aims to illuminate how IPV affects individual and community health and to identify public health interventions. Moreover, the current paper serves to advocate for urgent, coordinated action across policy, practice, and public health regarding IVP.

LITERATURE REVIEW

The review covered the period from 1 October to 30 October and involved a comprehensive search of key academic databases related to IPV, abuse, health outcomes, mental health, and public health prevention. To ensure a thorough examination of the literature, a multi-database search was conducted. Databases consulted included PubMed, Wiley, Scopus, Social Work Abstracts, Psychology Abstracts, and Burnout and Alexithymia Studies Worldwide. I preferred these databases because while PubMed and Scopus offer broad biomedical and epidemiological evidence; Wiley and Social Work Abstracts + Psychology Abstracts add depth in clinical psychology, intervention, policy, and social practice; the global burnout/alexithymia resource adds a nuanced lens on emotional processing and caregiver burden. To refine the search and ensure relevance and currency, strict inclusion criteria were applied. The analysis was limited to peer-reviewed scientific articles published within the past ten years and written in Turkish or English. This approach enabled a focused review of recent and methodologically robust research on the terms “IPV”, “health outcomes of violence”, and “public health prevention”. In total, 33 peer-reviewed sources were included.

THE BURDEN OF IPV: PHYSICAL, PSYCHOLOGICAL, AND SOCIETAL COSTS

The burden of IPV extends far beyond isolated abusive acts, producing physical, physical, psychological, and societal harms that affect individuals, families, and communities[17]. Physically, IPV results in acute injuries, chronic pain, and a cascade of long-term health problems, including cardiovascular, gastrointestinal, and immune dysfunction, increase healthcare use and disability[18]. Psychologically, survivors commonly experience depression, anxiety, post-traumatic stress disorder, sleep disturbances, and substance use, all of which impair daily functioning, employment, and social relationships. Societally, the consequences include increased medical and legal costs, lost productivity, demands on health and social services, and adverse outcomes for children who witness or experience violence, thereby perpetuating cycles of disadvantage[19]. As a public health crisis, IPV requires integrated prevention efforts, effective interventions, and sustained support aimed at reducing harms, addressing root causes, and promoting resilient communities.

A case example derived from anonymized clinical observations illustrates this burden[20]. A 32-year-old woman, experiences repeated minor to moderate injuries over a two years period, including facial contusions, a fractured rib, and chronic musculoskeletal pain in the neck and shoulders. She develops irritable bowel syndrome and intermittent headaches, likely related to ongoing stress and pain. Sleep is disrupted by fear and hypervigilance, contributing to fatigue and reduced endurance for daily activities. She makes multiple primary care visits and one urgent care visit, with several missed appointments due to transportation barriers and fear of retaliation if she seeks care without the abuser present. She reports persistent sadness, diminished interest in activities, irritability, and sleep disturbances. Screening reveals moderate depressive symptoms and intermittent panic attacks. She experiences intrusive memories of escalating violence, hyperarousal (startle responses and hypervigilance), and avoidance of places or situations that remind her of the abuse. She struggles with lowered self-esteem and engages in avoidance coping, relying on alcohol on weekends to numb distress, briefly worsening her sleep and mood. Fear of judgment, concerns about child welfare involvement, and stigma delay help-seeking and limit access to specialized IPV services, counseling, and safety planning. The intertwined physical and psychological effects reinforce one another, hindering recovery and sustainable functioning. Protective factors such as social support, confidential healthcare, IPV-specific counseling, and safety planning are crucial for breaking this cycle and improving outcomes[21].

The societal costs of IPV weaken community functioning and national capacity. At the macro level, IPV generates substantial economic burdens through increased healthcare use, social services, and legal system involvement[22]. Hospitals and clinics experience increased emergency department visits, chronic care needs, and mental health consultations, while social services grapple with housing support, child protection, and safety planning. These demands strain public budgets and divert resources from other priorities. Beyond financial effects, IPV undermines social cohesion and trust[23]. Survivors may withdraw from social networks, experience stigma, and face barriers to civic participation, weaking collective resilience. Schools and workplaces are also affected through disrupted learning, reduced productivity, and higher turnover, all of which impair educational outcomes and organizational performance[24]. When children witness IPV the effects extend across generations, influencing future relationships, educational attainment, and long-term economic opportunities, thereby entrenching cycles of disadvantage. Public health implications are central to understanding societal costs. The chronic stress and trauma associated with IPV contribute to population-level burdens of mental illness, cardiovascular risk, and behavioral health problems, increasing chronic disease prevalence and associated healthcare costs[25]. The criminal justice system also bears significant expenses, from policing to prosecutions and incarceration, while child welfare interventions add additional financial and social costs. Recognizing IPV as a societal rather than private issue highlights the need for comprehensive, cross-sector strategies that integrate prevention, early intervention, trauma-informed care, and structural supports such as housing stability, economic security, and confidential survivor-centered services.

RISK AND PROTECTIVE FACTORS ACROSS THE LIFESPAN

Across the lifespan, IPV risk emerges from a complex interplay of individual, relational, community, and societal factors over time. In childhood, exposure to violence, family instability, and insecure attachment can shape emotions, coping styles, and expectations about relationships, increasing in adulthood[26]. Early experiences of economic hardship, parental conflict, or household substance use can also create conditions where coercive control and aggression are more likely. In adolescence and young adulthood, risk is heightened by peer norms that tolerate aggression, substance misuse, and relationship modals that equate power with control[27]. Conversely, protective factors: Secure attachments, positive role models, access to supportive mentors, healthy school and community environments, and opportunities for prosocial engagement, promote resilience and healthier relational expectations, reducing IPV risk later on.

In adulthood, individual risk factors such as past exposure to violence, personal experiences of coercion or abuse, substance use, poor impulse control, and mental health disorders can increase susceptibility to both perpetration and victimization[28]. Relational dynamics: Unresolved conflict, unequal power, controlling behaviors, and poor communication patterns, play pivotal roles in sustaining abuse. Protective factors at the interpersonal level include strong social networks, effective conflict-resolution skills, mutual respect, and healthy relationship norms. Economic stability and access to resources (housing security, healthcare, and legal protections) also buffer risk by reducing stress and enabling timely help-seeking[29]. Community-level protections: Access to safe housing, youth and family services, school-based prevention, and trauma-informed care within healthcare and social systems, can interrupt cycles of violence.

In later life, vulnerabilities associated with aging and chronic stress can intensify the impact of IPV, while protective factors such as elder advocacy services, caregiver support networks, and accessible medical and mental health care become increasingly important[30]. Across all life stages, resilience is strengthened through early identification and intervention, educational and economic opportunities, supportive workplaces with IPV policies, and culturally competent services that respect diverse identities and experiences. Data-driven screening in healthcare settings, schools, and community organizations, combined with coordinated survivor-centered responses, enhances early detection and reduces the escalation. Ultimately, a life-course approach that strengthens protective factors and mitigates risk offers the most effective path to reducing harm and promoting safe, healthy relationships. A flow diagram illustrating pathways from risk factors to outcomes is presented in Figure 1.

Figure 1 Pathways from risk factors to outcomes. IPV: Intimate partner violence.

Male victimization in IPV is a real and under-recognized phenomenon. Although IPV is more frequently reported by women, men can experience physical, emotional, psychological, or financial abuse as well as coercive control and stalking within intimate relationships. They often face unique barriers to disclosure and help-seeking, including stigma, concerns about masculinity, and fear of not being believed[31]. A recent review found that one in five men was a victim of IPV[32]. Cultural variation also shapes how male victimization is perceived and addressed. Some cultures discourage reporting, normalize gender-based power imbalances, or expect parity in gender roles that makes male distress less visible. In other contexts, supportive norms and accessible services for men exist but may be limited by language, immigration status, or socioeconomic barriers[33]. These norms and social structures profoundly influence the occurrence, recognition, and effectiveness of responses to IPV. Norms that valorize rigid gender roles, male dominance, or the acceptability of using coercion to “discipline” partners increase both the risk and concealment of IPV by normalizing controlling behaviors and minimizing non-physical harms such as psychological abuse and coercive control[31].

Tolerance of violence within communities: Reinforced by family expectations, religious interpretations, or peer networks, reduces help seeking by survivors and discourages bystander intervention. Stigma and shame, especially among men, lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority people, and elderly survivors, further suppress disclosure[34,35]. Social structures also mediate these cultural influences. Limited healthcare accessibility, lack of confidential screening, under-resourced advocacy services, and weak legal protections or inconsistent enforcement leads to low identification and poor outcomes. Where laws exist but are biased, underenforced, or gender insensitive, survivors may avoid reporting due to fears of retaliation, loss of custody, or disbelief. Conversely, robust legal frameworks paired with accessible, culturally competent services and trained providers increase reporting, referrals, and intervention efficacy. Finally, intersecting social determinants: Poverty, immigration status, race, and disability, compound vulnerability and shape which interventions are feasible and acceptable. These realities underscore that effective prevention and response must address both cultural norms and structural barriers to be equitable. Comprehensive responses require inclusive screening, gender-sensitive interventions, and safe, stigma-reducing pathways to support that validate men’s experiences while promoting accountability and safety for all partners.

THE PUBLIC HEALTH IMPERATIVE: WHY NOW?

IPV is not only a personal tragedy but also a pressing public health emergency with immediate and long-term effects on social well-being. Yeh et al[36] published a significant paper in World Journal of Psychiatry titled “Mental and physical health outcomes among IPV survivors in Taiwan: A nationwide registry-based case control study”. The study assessed psychiatric and physical health risks following IPV exposure using nationwide registry data from Taiwan’s Health and Welfare Data Science Center. The authors found that IPV was associated with substantially higher 12-month risks of major psychiatric disorders: Depressive disorders, bipolar disorder, schizophrenia, and alcohol/substance use disorders. They also identified a modest but significant increase in asthma among Taiwanese adults exposed to IPV, after accounting for demographic and socioeconomic factors.

In recent years, growing recognition of IPV’s prevalence, its disproportionate impact on marginalized groups, and its links to chronic diseases, mental health crises, and intergenerational harm has intensified calls for coordinated action[37-39]. The convergence of economic stress, housing instability, and social dislocation: Exacerbated by global crises and shifting norms around gender and power, has increased exposure and vulnerability. This makes prevention, early intervention, and survivor-centered care more critical than ever. Addressing IPV now presents high-yield opportunities to reduce healthcare costs, improve mental and physical health outcomes, strengthen families, and build safer, more resilient communities through evidence-based policies, trauma-informed services, and cross-sector collaboration.

CONCLUSION

IPV is not a collection of isolated incidents but a pervasive, preventable threat to health, dignity, and social fabric. Across the health system, households, schools, workplaces, and communities, IPV exacts a heavy toll: Physically injuring bodies, eroding mental well-being, and generating costs that ripple through economies and future generations. The burden is not evenly shared; it disproportionately harms vulnerable groups, amplifying inequalities and underscoring the urgency of equity-centered responses. Yet IPV is not an intractable fate. By recognizing IPV as a solvable public health problem, we can transform it to a societal priority supported by governments, non-governmental organizations, or healthcare providers. This priority should include, prevention, early intervention, trauma-informed care, and structural supports such as housing stability, access to confidential services, economic opportunity. Universal screening protocols are now explicitly connected to the elevated psychiatric risks such as reinforcing the rationale for routine mental health assessment in IPV contexts, risk stratification, and timely referral to trauma-informed services.

A life-course lens reveals both risk and protection that shape trajectories: From childhood exposure and adolescent norms to adulthood dynamics and elder care. Targeted strategies at each life stage, prevention programs in schools including; comprehensive dating violence prevention curricula (examples: Safe dates, dating matters) combining classroom sessions, bystander training, and school policy changes, universal screening in healthcare including; school-based clinics, adolescent primary care and sexual/reproductive health services: Routine, confidential screening for relationship safety, survivor-centered navigation of safety and services including; digital-safety education focusing on online coercion, image-based abuse, and privacy, community-based supports, and just, efficient legal and social systems, can disrupt cycles of violence and reduce harm.

Also, intervention programs should be developed regarding the risks of developing alcohol and substance addiction, schizophrenia, bipolar disorder and other psychiatric illnesses that may be encountered in individuals exposed to IPV. Various research hold that digital technology could provide an early indication of violent intent and predict future violence. Also, using technology-based applications such as social media, mobile health components and other internet data for violence prevention encourage scholarly engagement, all while reinforcing themes of equity, and resilience in the community. The time to act is now: Investing in prevention, strengthening health and social services, and coordinating across sectors will yield substantial gains in health outcomes, social cohesion, and economic resilience. To translate this momentum into lasting change, we must operationalize four elements: (1) Universal screening and trauma-informed care embedded in health, social, and justice systems; (2) Evidence-based prevention that engages communities, challenges harmful norms, and builds healthy relationship skills from an early age; (3) Survivors’ autonomy and safety at the center of all services, with protections against retaliation and stigma; and (4) Robust data, accountability, and shared metrics to monitor progress, allocate resources wisely, and sustain political and public will.

ACKNOWLEDGEMENTS

I thank the authors for drawing attention to intimate partner violence, a matter of significant public-health concern, and for illustrating its urgency through a compelling case study.