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Intimate partner violence: treating abuser and abused

Alison Heru is Associate Professor of Psychiatry and Human Behavior (Clinical) at Brown Medical School (Butler Hospital, 345 Blackstone Boulevard, Providence, Rhode Island 02906, USA. Email: aheru{at}butler.org). She received her medical degree from Glasgow University, Scotland, and her psychiatric training in Edinburgh, Kingston Jamaica and at Brown University. Dr Heru and her colleagues have recently completed a study of the prevalence of intimate partner violence in patients hospitalised with suicidal ideation. As a result of this study, she is developing a couples treatment that includes a component for managing intimate partner violence.

Intimate partner violence is associated with significant psychiatric comorbidity. Treatment has focused on male perpetrators but recent studies indicate that this is of limited success in reducing male violence. This article reviews the current available treatments from three perspectives: that of the victim, the perpetrator, and the couple who wish to remain together. It also provides guidelines to assist the general psychiatrist in determining what treatment to offer patients who present with intimate partner violence. Guidelines emphasise the need for assessment of risk factors that indicate a potentially lethal relationship and the importance of the diagnosis and treatment of comorbidity, especially alcohol misuse and dependence.