New research reveals that women who are victims of domestic violence hide wide-ranging physical and mental health problems beyond the initial trauma.

The study, led by Claudia Garcia-Moreno of the World Health Organization, is the most far-reaching assessment yet into domestic violence in developing countries.

More than 24,000 women between the ages of 15 and 49, participating in the study, were asked if they had experienced physical or sexual violence by a current or former male partner. Those reporting violence were further asked if they had any subsequent physical and mental health problems.

The study was performed between 2000 and 2003 and included women from Bangladesh, Brazil, Ethiopia, Namibia, Peru, Samoa, Serbia and Montenegro, Thailand and the United Republic of Tanzania.

Many women said they had specific symptoms such as difficulty walking, trouble performing daily activities, pain, memory loss, dizziness and vaginal discharge. These women also reported increased emotional distress and suicidal thoughts or attempts, compared to women who had never been abused by their male partner. Moreover, the mental issues seem to last long after the violence has ended, the study found.

Differences in age, education or marital status did not appear to influence the association between partner violence and these physical and mental health problems in women.

“In addition to being a breach of human rights, the high prevalence of partner violence and its associations with poor health – including implied costs in terms of health expenditures and human suffering – highlight the urgent need to address partner violence in national and global health-sector policies and programs,” the study authors said.

“Violence is not only a substantial health problem by virtue of its direct effects, such as injury and mortality,” the researchers concluded, but also “as a risk factor for several other serious health problems.”

In an editorial accompanying the report in the British medical weekly The Lancet, epidemiologist Riyadh K. Lafta, M.D., of Mustansiriya Medical School in Baghdad said accurate data that can be compared across countries may help strengthen advocacy efforts and guide preventive interventions.

“Domestic violence against women is a worldwide problem. Future studies with a longitudinal cohort design should go further to measure the mortality and life expectancy among women who are victims in intimate-partner violence,” he said.