Effect of intimate partner violence on depression severity among women in informal settlements of Uganda

Preventive measures to disrupt COVID-19 transmission negatively impacted mental health, especially among women. Increasing cases of intimate partner violence (IPV) in socio-economically disadvantaged populations such as informal settlement dwellers were documented. We examined the longitudinal effect of IPV on depression symptoms among women in informal settlements during the COVID-19 onset in Kampala, Uganda.

This longitudinal study surveyed 148 adult women living in three purposively selected informal settings of Kampala, Uganda. Baseline and two follow-up surveys were conducted three weeks apart during the first COVID-19 wave. Our outcome was depression symptoms, a continuous variable score measured using a validated patient health questionnaire-9 tool. IPV data were collected using the modified conflict tactics scale. Two sample t-tests compared mean depression scores within each IPV category. Mixed effects linear models tested the independent association between any IPV exposure and depression symptom severity while controlling for random effects and interaction terms between IPV exposure and time points.

Among 148 respondents (mean age 33.09 ± 9.33 years), 58.1% experienced at least one form of IPV. Mean depression scores declined from 8.74 (± 5.71) at baseline to 7.22 (± 5.26) at midpoint and 6.60 (± 6.13) at endline. At baseline, 27.03% had none/minimal depression and 2.7% had severe depression. In the mixed effects linear models, compared to baseline, depression symptom scores significantly decreased by 3.03 at endline (Coef. -3.03, 95%CI -4.80,-1.26, p = 0.001), controlling for confounders. IPV exposure at mid-point was associated with a non-significant 1.41-unit increase in depression symptoms (Coef. 1.41, 95%CI -1.05,3.88, p = 0.282). However, at endline, IPV exposure was significantly associated with a 2.79-unit increase in depression symptoms when compared to baseline (Coef. 2.79, 95%CI 0.32,5.27, p = 0.027).

The increase in depression severity among women exposed to IPV underscores the compounding effects of IPV during early phases of the pandemic. Public health responses to outbreaks should integrate mental health support and violence prevention strategies, particularly for women experiencing IPV. Future research should explore the long-term impact of the pandemic on mental health, especially in informal settlements.