Double Burden: Anxiety Symptoms and Chronic Conditions Compound Poor Health Outcomes Among Survivors of Intimate Partner Violence

BACKGROUND: Experiencing intimate partner violence (IPV) is linked to poorer health and wellbeing, yet the interplay between physical and psychological comorbidities remains underexplored. This study evaluates the compounded burden of chronic illness and anxiety on self-perceived health in a national cohort of IPV survivors. METHODS: database with accessible medical records who reported experiencing IPV answered questions from validated questionnaires about anxiety history, perceived overall health, and social satisfaction. Four groups were established: controls, high anxiety and a chronic condition, only high anxiety, and only a chronic condition. Chronic conditions were based on SNOMED codes (e.g., HTN, DM, COPD, and autoimmune conditions). Weighted propensity scores balanced cohorts based on age, sex, education, and race/ethnicity. Proportional odds logistic regressions predicted the odds of reporting negative overall health and social satisfaction based on exposure group. RESULTS: Compared to controls, IPV survivors with both high anxiety and a chronic condition had greater odds of reporting worse overall health (OR = 3.30, 95% CI [3.01-3.63]) and lower social satisfaction (OR = 2.11, [1.92-2.31]). Those with either high anxiety or a chronic disease, to a lesser degree, reported worse overall health (OR [1.34(1.22-1.48), 2.28(2.03-2.56)] and lower social satisfaction (OR [1.52(1.38-1.66), 1.26(1.12-1.41)]. CONCLUSIONS: Anxiety symptoms and chronic illness are strongly associated with poorer perceived health and social satisfaction among IPV survivors. While each comorbidity negatively impacted perceived health, their combined burden conferred the greatest risk. The data suggest that chronic conditions exert a greater impact on perceived overall health, while anxiety is more strongly linked to lower social satisfaction, indicating benefits for clinical interventions that prioritize physical health for those with chronic illness and psychosocial support for those with anxiety.