Economic abuse and its associations with symptoms of common mental disorders among women in a cross-sectional survey in informal settlements in Mumbai, India

Suman Kanougiya,Muthusamy Sivakami,Nayreen Daruwalla,Apoorwa Deepak Gupta,Lu Gram,David Osrin

doi:10.1186/s12889-021-10904-8

Abstract

BackgroundDomestic violence takes a range of interconnected forms, of which economic abuse is common, but less studied than others. We examine the prevalence of economic abuse, its determinants, and its association with symptoms of depression, anxiety, and suicidal ideation.MethodsOur cross-sectional survey in informal settlement areas in Mumbai, India, asked women aged 18–49 years 15 questions about acquisition, use, and maintenance of economic resources, demographic and socioeconomic factors, and physical, sexual, and emotional violence. We administered the Patient Health Questionnaire 9 (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7) scales and asked about suicidal thinking. Determinants of economic abuse and its associations with positive screens for depression and anxiety were explored in univariable and multivariable logistic regression models.ResultsOf 4906 ever-married women respondents, 23% reported at least one form of economic abuse by either an intimate partner or another family member. The commonest were denial of property rights (10%), not being trusted with money (8%), and coercive appropriation of belongings (7%). Economic abuse was more commonly reported by widowed, separated, or divorced women than by married women (aOR 12.4; 95% CI 6.4, 24.1), and when their partners used alcohol or drugs (aOR 1.4; 95% CI 1.2–1.7). Women had greater odds of reporting economic abuse if they had suffered emotional (aOR 6.3; 95% CI 5.0–7.9), physical (aOR 1.9; 95% CI 1.4–2.6), or sexual violence (aOR 5.4; 95% CI 3.6–8.1) in the preceding 12 months. Economic abuse was independently associated with positive screens for moderate-severe depression (aOR 2.6; 95% CI 2.0–3.4), anxiety (aOR 2.7; 95% CI 1.9–3.8), and suicidal ideation (aOR 2.2; 95% CI 1.5–3.1). The odds of anxiety and depression increased with each additional form of economic abuse.DiscussionTo our knowledge, this is the first community-based study in India of the prevalence of economic abuse and its associations with symptoms of common mental disorders. It provides empirical support for the idea that economic abuse is at least as harmful to women’s mental health as physical violence. Surveys should include questions on economic abuse and prevention and intervention strategies need to help survivors to understand its forms.

Highlights

Domestic violence takes a range of interconnected forms, of which economic abuse is common, but less studied than others
We examined the association of symptoms of common mental disorders with economic abuse in a series of univariable and multivariable logistic regression models with moderate or severe depression, moderate or severe anxiety, and suicidal thoughts or action in the last 12 months as dependent variables
Our study examined past year experience of domestic violence and current mental health, and we could not investigate whether symptoms of common mental disorder led to subsequent reporting of violence or vice-versa

Summary

Introduction

Domestic violence takes a range of interconnected forms, of which economic abuse is common, but less studied than others. Violence against women occurs across all regions, societies, and cultures [1] It is a serious public health concern which affects the physical [2], reproductive [3], mental [4, 5], and social wellbeing of more than onethird of women [6]. Global considerations have focused on intimate partner violence, a form of domestic violence described as “any behaviour by a current or former male intimate partner within the context of marriage, cohabitation or any other formal or informal union, that causes physical, sexual or psychological harm” [6]. India’s Protection of Women from Domestic Violence Act, 2005, defines domestic violence as occurring within a domestic relationship: “a relationship between two persons who live or have, at any point of time, lived together in a shared household, when they are related by consanguinity, marriage, or through a relationship in the nature of marriage, adoption or are family members living together as a joint family.” [14]

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