Archives of Women's Mental Health

, Volume 21, Issue 3, pp 259–269 | Cite as

Psychiatric comorbidity and intimate partner violence among women who inject drugs in Europe: a cross-sectional study

  • Judit Tirado-Muñoz
  • Gail Gilchrist
  • Gabriele Fischer
  • Avril Taylor
  • Jacek Moskalewicz
  • Cinzia Giammarchi
  • Birgit Köchl
  • Alison Munro
  • Katarzyna Dąbrowska
  • April Shaw
  • Lucia Di Furia
  • Isabella Leeb
  • Caroline Hopf
  • Marta TorrensEmail author
Original Article


Women who inject drugs (WWID) are an especially vulnerable group of drug users. This study determined the prevalence of psychiatric comorbidity and intimate partrner violence (IPV), and factors associated with psychiatric comorbidity among WWID recruited from drug treatment services (67%) and harm reduction services in five European regions in Austria, Catalonia, Italy, Poland, and Scotland. Psychiatric comorbidity was assessed among 226 WWID using the Dual Diagnosis Screening Instrument. IPV was assessed using the Composite Abuse Scale and injecting and sexual risk behaviors were assessed using a battery of questionnaires adapted and developed for the study. Eighty-seven percent met criteria for at least one lifetime psychiatric disorder. The most common disorders were depression (76%), panic (54%), and post-traumatic stress (52%). WWID recruited in drug treatment services were almost three times as likely (OR 2.90 95% CI 1.30–6.43; p = 0.007) to meet criteria for a lifetime psychiatric disorder than those recruited from harm reduction services, specifically dysthymia (OR 5.32 95% CI 2.27–12.48; p = 0.000) and post-traumatic stress disorder (OR 1.83 95% CI 1.02–3.27; p = 0.040). WWID who reported sharing needles and syringes were almost three times as likely to meet criteria for lifetime psychiatric comorbidity than those who did not (OR 2.65 95% CI 1.07–6.56). Compared to WWID who had not experienced IPV, victims (70%) were almost two times more likely to meet criteria for post-traumatic stress disorder (OR 1.95 95% CI 1.10–3.48). Psychiatric comorbidity and IPV among WWID are common. Drug treatment and harm reduction services should address psychiatric comorbidity and IPV to improve treatment outcomes.


Cross-sectional study Europe Intimate partner violence Psychiatric disorder Women who inject drugs 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical Committee approval was granted by the relevant university or health service in each country before the study began: Austria (Ethics Committee of the Medical University of Vienna); Spain (Ethics Committee of Clinical Research- Parc de Salut Mar), Italy (Ethics Committee of the Azienda Sanitaria Unica Regionale Marche), Poland (Bio-ethical Committee at the Institute of Psychiatry and Neurology) and Scotland (University of West of Scotland Ethics Committee). Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2017

Authors and Affiliations

  • Judit Tirado-Muñoz
    • 1
  • Gail Gilchrist
    • 2
  • Gabriele Fischer
    • 3
  • Avril Taylor
    • 4
  • Jacek Moskalewicz
    • 5
  • Cinzia Giammarchi
    • 6
  • Birgit Köchl
    • 3
  • Alison Munro
    • 4
  • Katarzyna Dąbrowska
    • 5
  • April Shaw
    • 4
  • Lucia Di Furia
    • 6
  • Isabella Leeb
    • 3
  • Caroline Hopf
    • 3
  • Marta Torrens
    • 7
    • 8
    Email author
  1. 1.Addiction Research GroupIMIM—Institut Hospital del Mar d’Investigacions MèdiquesBarcelonaSpain
  2. 2.National Addiction Centre, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  3. 3.Addiction Clinic, Medical University of ViennaViennaAustria
  4. 4.School of Social SciencesUniversity of the West of ScotlandPaisleyScotland
  5. 5.Department of Studies on Alcoholism and Drug DependenceInstitute of Psychiatry and NeurologyWarsawPoland
  6. 6.Servizio Salute Regione MarcheAnconaItaly
  7. 7.Institute of Neuropsychiatry and AddictionsParc de Salut MarBarcelonaSpain
  8. 8.Universitat Autònoma de BarcelonaBarcelonaSpain

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