INTRODUCTION:
Intimate partner violence (IPV) predominately affects women and involves physical, sexual, emotional or psychological abuse by an intimate partner. IPV affects approximately one third of women worldwide[1]. Furthermore, it has been shown that there is a strong association between IPV and mental health such as depression and depressive symptoms[2]. Women who experience IPV are at higher risk of experiencing PTSD, anxiety disorders and suicidal ideation; but it has also been shown that those with depressive symptoms are at greater risk of being victims of IPV[3-5]. The aim of the study is to examine the bi-directional relationship between depressive symptoms and experience of IPV in adult women in South Africa.

METHODS:
Data from a longitudinal cluster randomized trial conducted in eThekwini, South Africa was used to model depression and IPV bi-directionality in women[6]. Depression was measured using the Center for Epidemiologic Studies Depression scale. Recent severe IPV was used, which looked at women’s experience of physical and/or sexual violence by an intimate partner. A bivariate probit model to jointly model the two outcomes was used and then longitudinal structural equation modeling (SEM) to explore the bi-directional relationship between IPV and depression. The analysis was multi-group and looked at whether women in the intervention group differed from those in the control group.

RESULTS:
A high correlation was found between IPV and depression. The SEM results indicate that there is some bi-directionality between depressive symptoms and severe IPV, but previous depressive symptoms seem to predict current experiences of severe IPV.

CONCLUSIONS:
Determining the causal relationship between depressive symptoms and IPV experiences is necessary, especially in South Africa, where high levels of violence against women exist. A multicomponent intervention approach is required to break a cycle in which poor mental health makes vulnerable women more prone to become victims of abuse.