Association between intimate partner violence and risk of self-harm: A population-based study using the UK Biobank

To examine the association between IPV victimization and self-harm and whether it varies by IPV characteristics and suicidality.

This nested case-control study used data from the UK Biobank. IPV and self-harm were assessed in the 2016-2017 Mental Health Questionnaire. Among 157,298 respondents, 23,566 participants reported with self-harm were age-and-sex matched to 117,830 controls without self-harm. Self-harm was defined as self-reported intentional self-injury or self-poisoning. Conditional logistic regression was performed to estimate odds ratios (ORs) between IPV and self-harm.

The median age at MHQ assessment was 61 years old, with the majority to be female participants (65.6%). Exposure to any IPV was significantly associated with an increased risk of self-harm (fully-adjusted OR, 2.78; 95% CI, 2.69-2.86), with a clear dose-response relationship by number of IPV types (all P for trend <0.001). The association was similar in both females and males. Sexual violence (OR 2.58 [2.27-2.93]), particularly combined with psychological violence (OR 4.28 [3.90-4.69]), showed the highest risk increase of self-harm. Moreover, males exposed to psychological violence, alone or with physical violence or sexual violence, had higher risks than females. The positive association between IPV and self-harm remained robust independent of times and methods used for self-harm, and regardless of intention to suicide.

Although more commonly reported in females, IPV victimization was strongly associated with self-harm in both sexes and independent of suicidality, emphasizing the need for identification and tailored prevention strategies for suicidal and non-suicidal self-harm for IPV survivors of both sexes.