Assessment of post-traumatic stress disorders in women victims of intimate partner violence: a mixed methods comparison at initial care in coordinated and uncoordinated care facilities in France

Abstract

Abstract Background: Intimate Partner Violence (IPV) has serious consequences on the mental health of victims-survivors such as Post-Traumatic Stress Disorder (PTSD). « La Maison des Femmes » (MdF, Women’s Home) is a French original medical and social structure specifically dedicated to provide multidisciplinary care for victims-survivors of IPV. The main objective of this study was to examine the prevalence of PTSD in victims-survivors of IPV consulting at the MdF or in two Municipal Health Centers (MHCs) located in the same area of the Paris conurbation. Methods: We conducted an observational survey from July 2020 to June 2021 in the MdF and in two MHCs. All women aged 18 years and over having suffered from IPV were eligible. PTSD diagnosis was assessed using the PTSD self-report checklist of symptoms defined in the DSM-5 (PCL-5). We solicited data on the level of self-rated global health, the substances use, and the possibility of reaching women by phone in the 6 months following the inclusion visit. We also conducted qualitative interviews with a sub-sample of the women, asking for victims-survivors’ perceptions of the effect of the care provided at MdF and perceptions of their specific needs. Results: A total of 67 women (mean age: 34 years old [Standard Deviation=9.7]) responded to our questionnaire (40 in the MdF, 12 in the MHC-1 and 15 in the MHC-2). PTSD diagnosis was retained for 40 women (59.7%) (PCL-5 score ≥33). The prevalence of PTSD was quite similar between the three groups. Around 30% of participants (n=23) self-rated their global health as bad or very bad, less than 30% (n=18) of women were regular smokers. Six months after inclusion, a half of participants (52.2%) had been reached by phone. Analysis of the nine qualitative interviews clarified victims-survivors’ perceptions of the MdF’s specific care: social networking, multidisciplinary approach, specialized listening, healthcare facilities, evasion and “feeling at home”. Conclusions The prevalence of PTSD was high among the three centers. This mixed-methods comparison will serve as a pilot study for a larger comparative trial to assess the impact of the MdF on victims-survivors’ mental health outcomes comparatively with the impact of non-dedicated structures.