Skip to main content

Advertisement

SpringerLink
Log in

Factors associated with self-report of sexual violence against men and women with mental disorders in Brazil

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objectives

Patients with mental illness (PMI) are more vulnerable to sexual violence (SV). This study aimed at assessing factors associated with SV against PMI, stratified by gender in Brazil.

Methods

Cross-sectional multicenter study with a national sample of 2,475 PMI randomly selected from 26 psychiatric services. Odds ratios were estimated with 95% confidence interval using logistic regression.

Results

A high prevalence of lifetime SV against PMI was observed (19.8%) and it was higher among women (26.6%) than men (12.5%). Among women, episodes of SV were more often caused by intimate partners and in the domestic environment, and among men, by strangers and in the streets. Among women, the following variables were independently associated (p < 0.01) with SV: younger age, living alone, history of homelessness, previous psychiatric hospitalization, lifetime STD diagnosis, early debut of sexual intercourse, irregular condom use, receiving/offering money for sex, and psychiatric diagnosis. Among men, younger age, previous and earlier psychiatric hospitalization, lifetime illegal drug use, receiving/offering money for sex, and psychiatric diagnosis were independently associated with SV.

Conclusions

The prevalence of SV in the studied population was high, especially among women. Women have more behavior factors associated with SV and they need protection, especially those in isolation and socially deprived. However, men also suffer SV, usually more often during childhood than adulthood and special attention should be given to lifetime illegal drug use and earlier psychiatric hospitalization. Preventive actions beyond mental health are important, such as social and economic actions to improve the living conditions of PMI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R (2002) World report on violence and health. World Health Organization, Geneva

    Google Scholar 

  2. Chen LP, Murad MH, Paras ML, Colbenson KM, Sattler AL, Goranson EN, Elamin MB, Seime RJ, Shinozaki G, Prokop LJ, Zirakzadeh A (2010) Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis. Mayo Clin Proc 85(7):618–629

    Article  PubMed  Google Scholar 

  3. Ribeiro WS, Andreoli SB, Ferri CP, Prince M, Mari JJ (2009) Exposure to violence and mental health problems in low and middle-income countries: a literature review. Rev Bras Psiquiatr 31(Suppl 2):S49–S57

    PubMed  Google Scholar 

  4. Contreras JM, Bott S, Guedes A, Dartnall E (2010) Violencia sexual en Latinoamérica y el Caribe: Análisis de datos secundários. Iniciativa de Investigacion sobre La Violencia Sexual http://www.svri.org/ViolenciaSexualnaALenoCaribe.pdf. Accessed 03 April 2011 (in Spanish)

  5. Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH, WHO Multi-country Study on Women’s Health, Domestic Violence against Women Study Team (2006) Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet 7368(9543):1260–1269

    Article  Google Scholar 

  6. Venturi G, Recaman G, Oliveira S (2004) A mulher brasileira nos espaços público e privado [in Portuguese] 1a. ed. SãoPaulo: Editora Fundação Perseu Abramo

  7. Schraiber LB, D’Oliveira AF, Couto MT, Hanada H, Kiss LB, Durand JG, Puccia MI, Andrade MC (2007) Violence against women attending public health services in the metropolitan area of São Paulo, Brazil. Rev Saude Publica 41(3):359–367

    Article  PubMed  Google Scholar 

  8. Schraiber LB, D’Oliveira AF, França-Junior I, Diniz S, Portella AP, Ludermir AB, Valença O, Couto MT (2007) Prevalence of intimate partner violence against women in regions of Brazil. Rev Saude Publica 41(5):797–807

    Article  PubMed  Google Scholar 

  9. Schraiber LB, D’Oliveira AF, Couto MT (2006) Violence and health: recent scientific studies. Rev Saude Publica 40 Spec no:112–20

    Google Scholar 

  10. Manzolli P, Nunes MA, Schmidt MI, Pinheiro AP, Soares RM, Giacomello A, Drehmer M, Buss C, Hoffmann JF, Ozcariz S, Melere C, Manenti CN, Camey S, Ferri CP (2010) Violence and depressive symptoms during pregnancy: a primary care study in Brazil. Soc Psychiatry Psychiatr Epidemiol Oct 45(10):983–988

    Article  Google Scholar 

  11. Schraiber LB, D’Oliveira AF, França Junior I (2008) Intimate partner sexual violence among men and women in urban Brazil, 2005. Rev Saude Publica 42(Suppl 1):127–137

    Article  PubMed  Google Scholar 

  12. Sundaram V, Laursen B, Helweg-Larsen K (2008) Is sexual victimization gender specific? The prevalence of forced sexual activity among men and women in Denmark, and self-reported well-being among survivors. J Interpers Violence Oct 23(10):1414–1440

    Article  Google Scholar 

  13. Choudhary E, Coben J, Bossarte RM (2010) Adverse health outcomes, perpetrator characteristics, and sexual violence victimization among US adult males. J Interpers Violence Aug 25(8):1523–1541

    Article  Google Scholar 

  14. Schraiber LB, Gomes R, Couto MT (2005) Homens e saúde na pauta da saúde coletiva. [in Portuguese]. Ciênc Saúde Coletiva 10(2):7–17

    Article  Google Scholar 

  15. Tiet QQ, Finney JW, Moos RH (2006) Recent sexual abuse, physical abuse, and suicide attempts among male veterans seeking psychiatric treatment. Psychiatr ServJan 57(1):107–113

    Article  Google Scholar 

  16. Tyler KA, Beal MR (2010) The high-risk environment of homeless young adults: consequences for physical and sexual victimization. Violence Vict 25(1):101–115

    Article  PubMed  Google Scholar 

  17. Decker MR, McCauley HL, Phuengsamran D, Janyam S, Seage GR 3rd, Silverman JG (2010) Violence victimisation, sexual risk and sexually transmitted infection symptoms among female sex workers in Thailand. Sex Transm Infect 86(3):236–240

    Article  PubMed  Google Scholar 

  18. Wolff N, Blitz CL, Shi J, Bachman R, Siegel JA (2006) Sexual violence inside prisons: rates of victimization. J Urban Health 83(5):835–848

    Article  PubMed  Google Scholar 

  19. Choe JY, Teplin LA, Abram KM (2008) Perpetration of violence, violent victimization, and severe mental illness: balancing public health concerns. Psychiatr Serv 59(2):153–164

    Article  PubMed  Google Scholar 

  20. Lovell AM, Cook J, Velpry L (2008) Violence towards people with severe mental disorders: a review of the literature and of related concepts. Rev Epidemiol Sante Publique Jun 56(3):197–207

    Article  CAS  Google Scholar 

  21. Silver E (2002) Mental illness and violent victimization: the mediating role of involvement in conflicted social relationship. Criminology 40:191–212

    Article  Google Scholar 

  22. Silver E, Arseneault L, Langley J, Caspi A, Moffitt TE (2005) Mental illness and violent victimization in a total birth cohort. Am J Public Health 95(11):2015–2021

    Article  PubMed  Google Scholar 

  23. Teplin LA, McClelland GM, Abram KM, Weiner DA (2005) Crime victimization in adults with severe mental illness: comparison with the national crime victimization survey. Arch Gen Psychiatry 62:911–921

    Article  PubMed  Google Scholar 

  24. Sturup J, Sorman K, Lindqvist P, Kristiansson M (2011) Violent victimization of psychiatric patients: a Swedish case–control study. Soc Psychiatry Psychiatr Epidemiol 46(1):29–34

    Article  PubMed  Google Scholar 

  25. Chapple B, Chant D, Nolan P, Cardy S, Whiteford H, McGrath J (2004) Correlates of victimisation amongst people with psychosis. Soc Psychiatry Psychiatr Epidemiol 39(10):836–840

    PubMed  Google Scholar 

  26. Bengtsson-Tops A, Markstrom U, Lewin B (2005) The prevalence of abuse in Swedish female psychiatric users, the perpetrators and places where abuse occurred. Int J Psychiatry 59:504–510

    CAS  Google Scholar 

  27. Kim D, Kaspar V, Noh S, Nam JH (2006) Sexual and physical abuse among Korean female inpatients with schizophrenia. J Traumatic Stress 19(2):279–289

    Article  Google Scholar 

  28. Goodman LA, Salyers MP, Mueser KT, Rosenberg SD, Swartz M, Essock SM, Osher FC, Butterfield MI, Swanson J (2001) 5 Site Health and Risk Study Research Committee. Recent victimization in women and men with severe mental illness: prevalence and correlates. J Trauma Stress 14(4):615–632

    Article  PubMed  CAS  Google Scholar 

  29. Najavits LM, Sonn J, Walsh M, Weiss RD (2004) Domestic violence in women with PTSD and substance abuse. Addict Behav 29(4):707–715

    Article  PubMed  Google Scholar 

  30. Neria Y, Bromet EJ, Sievers S, Lavelle J, Fochtmann LJ (2002) Trauma exposure and posttraumatic stress disorder in psychosis: findings from a first-admission cohort. J Consult Clin Psychol 70(1):246–251

    Article  PubMed  Google Scholar 

  31. Shack AV, Averill PM, Kopecky C, Krajewski K, Gummattira P (2004) Prior history of physical and sexual abuse among the psychiatric inpatient population: a comparison of males and females. Psychiatr Q 75:343–359

    Article  PubMed  Google Scholar 

  32. McPherson DM, Delva J, Cranford AJ (2007) A longitudinal investigation of intimate partner violence among mothers with mental illness. Psychiatr Serv 58:675–680

    Article  PubMed  Google Scholar 

  33. Khalifeh H, Dean K (2010) Gender and violence against people with severe mental illness. Int Rev Psychiatry 22(5):535–546

    Article  PubMed  Google Scholar 

  34. Howard LM, Trevillion K, Khalifeh H, Woodall A, Agnew-Davies R, Feder G (2010) Domestic violence and severe psychiatric disorders: prevalence and interventions. Psychol Med 40(6):881–893

    Article  PubMed  CAS  Google Scholar 

  35. Goodman LA, Rosenberg SD, Mueser KT, Drake RE (1997) Physical and sexual assault history in women with serious mental illness: prevalence, correlates, treatment, and future research directions. Schizophr Bull 23(4):685–696

    Article  PubMed  CAS  Google Scholar 

  36. Lam JA, Rosenheck R (1998) The effect of victimization on clinical outcomes of homeless persons with serious mental illness. Psychiatr Serv 49(5):678–683

    PubMed  CAS  Google Scholar 

  37. Walsh E, Moran P, Scott C, McKenzie K, Burns T, Creed F, Tyrer P, Murray RM, Fahy T, UK700 Group (2003) Prevalence of violent victimisation in severe mental illness. Br J Psychiatry 183:233–238

    Article  PubMed  Google Scholar 

  38. Friedman SH, Loue S (2007) Incidence and prevalence of intimate partner violence by and against women with severe mental illness. J Womens Health 16(4):471–480

    Article  Google Scholar 

  39. Schomerus G, Heider D, Angermeyer MC, Bebbington PE, Azorin JM, Brugha T, Toumi M (2008) Urban residence, victimhood and the appraisal of personal safety in people with schizophrenia: results from the European Schizophrenia Cohort (EuroSC). Psychol Med 38(4):591–597

    Article  PubMed  CAS  Google Scholar 

  40. Glover K, Olfson M, Gameroff MJ, Neria Y (2010) Assault and mental disorders: a cross-sectional study of urban adult primary care patients. Psychiatr Serv 61(10):1018–1023

    Article  PubMed  Google Scholar 

  41. Lu W, Mueser KT, Rosenberg SD, Jankowski MK (2008) Correlates of adverse childhood experiences among adults with severe mood disorders. Psychiatr Serv 59(9):1018–1026

    Article  PubMed  Google Scholar 

  42. Hodgins S, Lincoln T, Mak T (2009) Experiences of victimisation and depression are associated with community functioning among men with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 44(6):448–457

    Article  PubMed  Google Scholar 

  43. WHO (2010) Addressing violence against women and HIV/AIDS: What works? Geneva: World Health Organization

  44. Meade CS, Kershaw TS, Hansen NB, Sikkema KJ (2009) Long-term correlates of childhood abuse among adults with severe mental illness: adult victimization, substance abuse, and HIV sexual risk behavior. AIDS Behav 13(2):207–216

    Article  PubMed  Google Scholar 

  45. Guimarães MDC, Campos LN, Melo AP, Carmo RA, Machado CJ, Acurcio FA PESSOAS, Project Network Group (2009) Prevalence of HIV, syphilis, hepatitis B and C among adults with mental illness: a multicenter study in Brazil. Rev Bras Psiquiatr 31(1):43–47

    Article  PubMed  Google Scholar 

  46. Guimarães MDC, Oliveira HN, Campos LN, Santos CA, Gomes CER, Oliveira SB et al (2008) Reliability and validity of a questionnaire on vulnerability to sexuality transmitted infections among adults with chronic mental illness–PESSOAS Project. Rev Bras Psiq 30(1):55–59

    Article  Google Scholar 

  47. Kahn HA, Sempos CT (1997) Statistical methods in epidemiology. 2nd edn, Oxford University Press, New York

  48. Hosmer DW, Lemeshow S (1989) Applied logistic regression. Wiley, New York

    Google Scholar 

  49. Coverdale JH, Turbott SH (2000) Sexual and physical abuse of chronically ill psychiatric outpatients compared with a matched sample of medical outpatients. J Nerv Ment Dis 188(7):440–445

    Article  PubMed  CAS  Google Scholar 

  50. Frueh BC, Knapp RG, Cusack KJ, Grubaugh AL, Sauvageot JA, Cousins VC, Yim E, Robins CS, Monnier J, Hiers TG (2005) Patients’ reports of traumatic or harmful experiences within the psychiatric setting. Psychiatr Serv 56(9):1123–1133

    Article  PubMed  Google Scholar 

  51. Moura LBA et al. (2009) Violências contra mulheres por parceiro íntimo em área urbana economicamente vulnerável, Brasília, DF. Rev. Saúde Pública 43(6):944-53 (in Portuguese)

    Google Scholar 

  52. Marinheiro AL, Vieira EM, de Souza L (2006) Prevalence of violence against women users of health services. Rev Saude Publica Aug 40(4):604–610

    Google Scholar 

  53. Abramsky T, Watts CH, Garcia-Moreno C, Devries K, Kiss L, Ellsberg M, Jansen HA, Heise L (2011) What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women’s health and domestic violence. BMC Public Health 11:109

    Article  PubMed  Google Scholar 

  54. Goodman LA, Dutton MA, Harris M (1995) Episodically homeless women with serious mental illness: prevalence of physical and sexual assault. Am J Orthopsychiatry 65(4):468–478

    Article  PubMed  CAS  Google Scholar 

  55. Dean K, Moran P, Fahy T, Tyrer P, Leese M, Creed F, Burns T, Murray R, Walsh E (2007) Predictors of violent victimization amongst those with psychosis. Acta Psychiatr Scand 116(5):345–353

    Article  PubMed  CAS  Google Scholar 

  56. Rosenberg SD, Lu W, Mueser KT, Jankowski MK, Cournos F (2007) Correlates of adverse childhood events among adults with schizophrenia spectrum disorders. Psychiatr Serv 58(2):245–253

    Article  PubMed  Google Scholar 

  57. Waiselfisz JJ (2010) Mapa da violência 2010: Anatomia dos homicídios no Brasil [in Portuguese] Instituto Sangari, São Paulo-SP-Brasil

  58. BRASIL (2010) Ministério da Saúde. Secretaria de Vigilância em Saúde. Department de Análise de Situação de Saúde [in Portuguese] Viva: vigilância de violências e acidentes, 2008 e 2009/Ministério da Saúde, Secretaria de Vigilância em Saúde, Department de Análise de Situação de Saúde.–Brasília: Ministério da Saúde

  59. Maniglio R (2009) Severe mental illness and criminal victimization: a systematic review. Acta Psychiatr Scand 119(3):180–191

    Article  PubMed  CAS  Google Scholar 

  60. Saúde Mental no SUS: as novas fronteiras da Reforma Psiquiátrica [in Portuguese] Relatório de Gestão 2007-2010 (2011) Ministério da Saúde: Brasília

  61. Rose D, Trevillion K, Woodall A, Morgan C, Feder G, Howard L (2011) Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study. Br J Psychiatry 198:189–194

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was carried out by the Federal University of Minas Gerais with technical and financial support of the Ministry of Health/Secretary of Health Surveillance/Department of STD, Aids and Viral Hepatitis through the Project of International Technical Cooperation 914/BRA/1101 between the Brazilian Government and the United Nations Educational, Scientific and Cultural Organization––UNESCO.

Conflict of interest

None of the authors has any financial involvement or affiliation with any organization whose financial interests may be affected by material in the manuscript.

Author information

Authors and Affiliations

  1. Research Group in Epidemiology and Health Evaluation, Department of Preventive and Social Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Helian Nunes de Oliveira, Carla Jorge Machado & Mark Drew Crosland Guimarães

  2. Raul Soares Institute Teaching Hospital/HE-IRS-Hospital Foundation of the State of Minas Gerais–FHEMIG, Av. Contorno, 3017, Hospital de Ensino Instituto Raul Soares, Bairro Santa Efigênia, Belo Horizonte, Minas Gerais, CEP 30110-080, Brazil

    Helian Nunes de Oliveira

  3. Department of Demography, CEDEPLAR, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Carla Jorge Machado

Authors
  1. Helian Nunes de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carla Jorge Machado
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mark Drew Crosland Guimarães
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Helian Nunes de Oliveira.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Oliveira, H.N., Machado, C.J. & Guimarães, M.D.C. Factors associated with self-report of sexual violence against men and women with mental disorders in Brazil. Soc Psychiatry Psychiatr Epidemiol 47, 1567–1579 (2012). https://doi.org/10.1007/s00127-011-0463-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-011-0463-8

Keywords

Search

Navigation