Intimate Partner Violence and Suicide Risk among Women Presenting to Emergency Departments: A Systematic Review, Meta-Analysis, and Narrative Synthesis

Abstract

Women experiencing intimate partner violence (IPV) and suicide frequently present to emergency departments (EDs). While IPV and suicide are known to co-occur, there is a limited understanding of the intersection in ED presentations. This systematic review, meta-analysis, and narrative synthesis aimed to quantify the association between IPV and suicidality in women presenting to EDs and examine the factors that influence women’s suicide risk. Systematic searches of three databases identified 20 ED studies of 7,498 women, reporting associations between IPV and suicidal presentations (final search: 30 August 2025). Pooled prevalence and risk ratios (RRs) were estimated using five random-effects meta-analysis models, stratified by IPV type and suicide-related outcome. Narrative synthesis was used to examine factors associated with suicide risk. Study risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist. On average, 22% (95% CI [0.11, 0.36]) of women with suicide presentations had experienced physical IPV, while 13% [0.08, 0.18] of women with IPV histories reported suicidality. IPV was associated with a three-fold increased risk of suicide attempt (RR 3.00 [1.39, 6.47]), and psychological IPV demonstrated a stronger association (RR 3.23 [1.68, 6.19]) than physical IPV (RR 2.00 [1.26, 3.17]). High between-study heterogeneity was observed across all models ( I 2 > 75%), and a high risk of bias was identified in half of the studies. The robust associations detected between IPV and suicide attempt underscore the need for contextualised assessment within trauma-informed emergency care to strengthen clinical response and care pathways for women.