GP · abuse-and-violence
Domestic and family violence
Also known as Domestic violence · Intimate partner violence · Family violence
GP-fellowship guide to domestic and family violence: recognising DV presentations in general practice (direct disclosure, injuries, chronic pain, mental health), asking safely and directly, safety planning as the priority intervention, psychosocial interventions for survivors (depression SMD -0.15, PTSD SMD -0.15), culturally competent identification for migrant and refugee women (HARMONY study), and the GP role in long-term recovery.
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Target exams
Red flags
- Ask about DV directly and safely: 'Are you safe at home?' — do not wait for the patient to raise it
- Pregnancy is a high-risk period for DV onset or escalation — screen at antenatal booking and postnatally
- Never couples counsel in DV — it increases risk to the victim; see the patient alone
- Document DV findings objectively and thoroughly — they may be needed for legal proceedings
Overview
Domestic and family violence is a health issue of enormous scale. Globally, 608 million females aged 15 and older have been exposed to intimate partner violence, and IPV ranks as the fourth leading risk factor for DALYs in females aged 15-49.[1] Most survivors see a GP multiple times before they disclose — the consultation is the opportunity.
References4ShowHide
- [1]Micklitz HM, Glass CM, Bengel J, Sander LB Efficacy of Psychosocial Interventions for Survivors of Intimate Partner Violence: A Systematic Review and Meta-Analysis. Trauma Violence Abuse, 2024.PMID 37148270
- [2]GBD 2023 Intimate Partner Violence and Sexual Violence against Children Collaborators Disease burden attributable to intimate partner violence against females and sexual violence against children in 204 countries and territories, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet, 2026.PMID 41386261
- [3]Taft AJ, Young F, Hegarty KL, Yelland J, Mazza D, et al. A culturally-safe primary care intervention for migrant/refugee women suffering domestic violence and abuse: HARMONY-a pragmatic cluster randomised controlled trial. BMC Med, 2026.PMID 41864964
- [4]Khaefi N, Maarefvand M, Bidhendi-Yarandi R The Efficacy of Safety Plans in Mitigating Domestic Violence Experiences: A Tehran Study. J Interpers Violence, 2026.PMID 42479824