Physical intimate partner violence in Europe: results from a population-based multi-center study in six countries

INTRODUCTION: The prevalence, determinants and health consequences of physical intimate partner violence (IPV) in Western Europe has never been considered in a cross-cultural perspective, taking men and women involvement in the three patterns of violence: victims, perpetrators or both. METHODS: We assessed a representative sample of adults (18-64 years; N=3496) living in Athens-Greece, Porto-Portugal, Budapest-Hungary, London-United Kingdom, {\"O}stersund-Sweden and Stuttgart-Germany. Past-year physical IPV was assessed using the Revised-Conflict-Tactics-Scales. The association between IPV and child abuse, socioeconomics (education, occupation, unemployment duration), behavioral (alcohol) and health factors (chronic diseases, anxiety and depressive symptoms), by sex and IPV pattern, was estimated using age- and city-adjusted logistic regression odds ratios (AOR, 95\% confidence intervals). RESULTS: Physical IPV was reported by 17.7\% (16.0-19.4\%) of women (3.5\% victims-only, 4.2\% perpetrators-only and 10.0\% both victims and perpetrators) and by 19.8\% (17.8-22.0\%) of men (4.1\%, 3.8\% and 11.9\%, respectively). In general, Greek presented the highest and Portuguese the lowest estimates. History of child abuse increased the risk of all IPV patterns. In women, unemployment duration and blue collar occupation were associated with increased likelihood of all IPV patterns. In men, only unemployment duration was associated with increased perpetration and lower occupation with victimization. Heavy alcohol use, chronic diseases and self-assessment of health as poor or fair were significantly associated with female involvement in IPV, both as victim and perpetrator. Anxiety and depressive symptoms severity was higher in male and female declaring both victimization and perpetration. CONCLUSIONS: In these European men and women IPV was frequently experienced and child abuse a common determinant of victimization, perpetration or bi-directional violence. Irrespective of IPV pattern, socioeconomic inequalities were evident in females but less consistent in males. These findings confirm IPV as a major public health concern, and for those involved it significantly increases the burden of disease.