PT - JOURNAL ARTICLE AU - Fiona Duxbury TI - Recognising domestic violence in clinical practice using the diagnoses of posttraumatic stress disorder, depression and low self-esteem DP - 2006 Apr 01 TA - British Journal of General Practice PG - 294--300 VI - 56 IP - 525 4099 - http://bjgp.org/content/56/525/294.short 4100 - http://bjgp.org/content/56/525/294.full SO - Br J Gen Pract2006 Apr 01; 56 AB - This discussion paper reviews the health impacts, physical and mental, of domestic violence and explores the link between domestic violence and psychological symptoms. This paper focuses more on posttraumatic stress disorder (PTSD) than depression and low self-esteem because doctors are less familiar with PTSD. The barriers preventing health workers from detecting domestic violence are reviewed and the fear of health professionals that asking about trauma can harm patients is explored. The article then outlines practical strategies to improve detection of domestic violence using patients' presenting psychological symptoms and the diagnoses frequently associated with domestic violence namely, PTSD, depression and low self-esteem. It is argued that it is inadvisable to try to implement a policy of screening for domestic violence in general practice when the public health model is currently inappropriate. The paper discusses why the diagnostic frameworks of depression and PTSD are helpful in general practice, not only in detecting domestic violence but in working with the patient to establish trust and ways forward that can be tailored to meet the needs of the patient and their children. Patients' and professionals' dilemmas about what to do once domestic violence is detected are briefly explored.