The article published in the journal Nature Medicine analyses the health impact of intimate partner violence against women and childhood sexual abuse. To do so, the authors synthesise information published over a very long period (1970-2023) followed by a meta-analysis. The authors use a very conservative method of analysis which allows them to state that women who suffer intimate partner violence have at least a 65% higher risk of suffering a severe depressive disorder and at least a 35% higher risk of suffering an abortion. In girls and boys exposed to sexual abuse in childhood, the authors confirm an increased risk of problematic alcohol consumption (45%) as well as an increased risk of self-harm (35%).  

Although not included in the study, it is important to note that witnessing maternal violence also impacts on the health of children, increasing the risk of intimate partner violence later in life. In this sense, as the article underlines, it is necessary both to prevent the violence suffered by women and children and to detect it early so that they can recover their wellbeing and minimise the impact of violence throughout their lives. In this task, health and social services have a strategic role that requires human and material resources and training.

Intimate partner violence against women and child sexual abuse are two serious social problems, but also health problems, not least because of the consequences they have on the physical, mental and social health of their victims. 

This is why studies such as that of Spencer et al. (2023) are very welcome: they provide solid evidence on these consequences based on a systematic review of the literature on the subject, which allows us not only to broaden our knowledge on the subject, but also to develop more and better lines of intervention for tertiary prevention (minimisation of sequelae) in these cases. 

It should be noted, however, that this work focuses on a limited number of consequences (5 in the case of intimate partner violence against women, 15 in the case of sexual abuse), which, although relevant, are not the only ones. 

Therefore, it is to be hoped and encouraged that researchers will continue to advance and deepen the study of the subject, extending the work to other equally relevant and disabling consequences that also need to be addressed on the basis of solid evidence of their incidence and prevalence.

The study deals with a subject of great impact and importance for the physical, psychological, social and sexual health of the population, and specifically of women. There is still a need for scientific contributions that help to understand the consequences of having suffered violence for all aspects of health in our society. To be able to understand these consequences, having up-to-date, scientifically rigorous information and sharing it with society is undoubtedly the way to develop effective preventive programmes. For these reasons, it is of great relevance to continue putting efforts into research and studies such as the present one. 

The authors collect information and studies from an extensive period, including an extensive search and review. The conclusions are based on solid data from previously published studies, gathering and analysing the scientific background and updating knowledge. Particularly noteworthy in this work is the joint analysis of two types of violence that may seem different but are very likely to be connected, child sexual abuse and intimate partner violence. Both include the terrible fact that the person who is supposed to love and protect the victim is the one who inflicts the harm, creating a situation of dissonance. The consequences of living through these situations are not unique to the victim, but have an impact on the whole of society and its health system. The study highlights that the scientific community is still on the way to comprehensively identifying and understanding both types of violence, and opens the door to studying and considering violence against women and children together, focusing on the study of violence throughout life and perhaps analysing the possible relationships between both types of violence. There is still some way to go, and the fact that both types of violence are part of an often silenced reality that is highly complex to study makes it a challenge for future research. 

The clinical implications of this study are to better understand violence and its consequences, as well as to focus adequate attention on the victims. Raising awareness and making these abuses visible are key to tackling the reality.

A systematic review of the health effects of intimate partner violence against women and childhood sexual abuse confirms that both forms of violence pose significant health threats. Intimate partner violence is associated in women with major depressive disorder, for which the risk is increased by 63%, and with abortion, for which the risk is increased by 35%. In addition, intimate partner violence increases women's risk of HIV/AIDS, anxiety disorders and suicide attempts. 

Childhood sexual abuse is associated with alcohol use disorder, with a 45% increased risk, and with suicide attempts, with a 35% increased risk. It is also associated with major depressive disorder, anxiety disorder and asthma. Other health problems less frequently associated with childhood sexual abuse include Type 2 diabetes mellitus, HIV/AIDS, sexually transmitted infections, miscarriage, substance use disorder and conduct disorders. 

The article acknowledges that, although the lack of research limits our ability to understand the actual health impacts of violence, such impacts are greater than previously reported, and that increased efforts are needed to prevent violence and to treat survivors of violence.