In this study, data collected through National Mental Health Survey were analyzed to investigate the prevalence of violence and its association with mental health. Domestic and social violence prevalence among those older than 15 years was obtained as 11.4% and 5.5% in one month. With a prevalence of 61.8% and 66.8% for domestic and social violence, respectively, verbal violence was the most common type. Female gender, being younger than 25 years old, living apart together, unemployment, and low education level were significantly associated with domestic and social violence. The National Study of Mental Health, conducted by Noorbala et al. (2015), reported a one-year prevalence of 23.08% for domestic violence, 23.65%, and 22.52% for males and females, respectively. A prevalence of 8.7% is reported for social violence; 12 and 4.14% for males and females, respectively .
The observed reduced prevalence of violence, as compared to 2015, should not be interpreted as a declining trend because of the increased number of contacts with social emergency services since the onset of the COVID-19 outbreak and the negative consequences of the pandemic, including social and economic, indicate the increased occurrence of violence . Noteworthy, their study investigated the point prevalence (one month) of violence, while our study reported a one-year prevalence. Hence, the simple comparison of these two studies indicates a declining trend.
Although the government has devised various solutions over many years to deal with and reduce the problem of violence in different social groups, it is not enough and this problem is still prevalent, especially in the villages. Women's ignorance of their rights, which are stated in the constitution and civil laws, is the main factor of mental and physical vulnerability of people . Although domestic violence is a global phenomenon, it can have different definitions and rates of occurrence depending on the culture in which it occurs. In addition, unlike in Western countries where it is relatively easy for researchers to obtain and access information on various aspects of family violence, it is a big challenge in some countries, including Iran, due to inaccurate information . It is necessary for the criminal justice system at the level of legislation and implementation, using the experiences of other countries, to expand appropriate measures to ensure the right security of people against crime and victimization and to protect their right to aggression.
Several studies investigated domestic and social violence in Iran before and after the COVID-19 outbreak. A meta-analysis of studies performed before the COVID-19 outbreak reported a prevalence of 52% for psychological violence against women, 37% for physical violence, and 34% for social violence. In addition, the highest rate of violence against women is reported for those aged 20 to 30 years old (48.5%), and domestic violence against housewives is reported as 65.3%  which both domestic and social violence is higher than that of the present study. The observed difference can be attributed to the type of studies. Studies on VAW reported a prevalence of 2.3 to 73.78% for different developing countries. Physical and emotional-psychological violence prevalence ranges from 61.6 to 11.54% and 7.8 to 84.3%, respectively. Prevalence of sexual, economic, and verbal violence is reported as 0.8–58.8%, 13.7–43.7%, and 33.21–86.1%, respectively. The most common causes of VAW are structural, including early marriage and husband addiction, either drugs or alcohol .
Few studies have investigated the prevalence of violence since the COVID-19 outbreak in the general population of Iran. Yari et al. (2020) reported that during the early COVID-19 outbreak, the prevalence of domestic violence against Iranian women aged 19 to 65 years old was moderate by 57.2% and severe by 26.1%. They reported higher rates of psychological and sexual violence. The prevalence of domestic violence was higher among women younger than 25 years and illiterate women . A study intended to compare the prevalence of domestic violence among women aged 18 to 60 years old before and after the COVID-19 outbreak reported an increasing trend (i.e., from 54.2 to 65.4%). Furthermore, 25.5% of women had experienced domestic violence for the first time in their life after the COVID-19 outbreak, with a higher rate of psychological violence (14.7%) in comparison to physical (7%) and sexual violence (8.4%). The prevalence of domestic violence in women older than 50 years, housewives, illiterate women, and low-income families was significantly higher than in other groups  Regardless of the administered tool to measure domestic violence in these two studies, it seems that, based on the present study's findings, the prevalence of violence has declined since the early months of the COVID-19 outbreak. However, concerning the variable of age and its association with domestic violence, the findings of this study are not in line with Fereydony's study; while, Yari et al. reported similar results. The observed difference can be attributed to the study population and administered tool. A study conducted in Portugal on cases older than 16 years old reported similar results; an overall prevalence of 13.7% for violence. In contrast to the findings of this study, the Portugal study reported higher rates of psychological violence (13%) in comparison to sexual and physical violence .
Women and children are among the most vulnerable populations. Violence against women and children has a long history worldwide, regardless of social, economic, and cultural class or ethnicity, or race ). Since the onset of the COVID-19 outbreak, stay at home policy has been emphasized by several countries, which according to the evidence, is accompanied by an increased occurrence of violence worldwide. For instance, a review study reported that its prevalence has increased by 48% in the USA in comparison to before the COVID-19 outbreak . Therefore, countries should be aware that encouraging people to respect quarantine to cope with SARS-CoV-2 infection has turned into a paradox in terms of domestic violence. Women who have to spend time at home may experience social isolation, leading to the inability to seek help . Meanwhile, the WHO warned its members that quarantine, isolation, and social distancing could increase violence against women . Increased occurrence of VAW, particularly among younger women, indicates a severe barrier to improving gender inequalities. In other words, these findings should sound the alarm regarding the need for planning and introducing appropriate and in-time interventions to address its consequences.
Violence is often associated with increased psychological disorders . Also, prolonged exposure to stressors in women with a history of domestic violence is associated with an increased prevalence of post-traumatic stress disorder and depression. Meanwhile, increased resilience is reported as an adjusting factor in coping with these women's psychological disorders . According to the findings, the prevalence of domestic and social violence in cases suspected of mental disorders was significantly higher than in healthy subjects.
In a study by Mengo et al., 68.5% of women suffering from mental disorders experienced various levels of physical violence, and 71.4% reported sexual violence, which is higher than the rates of the present study . The observed difference can be attributed to the impact of cultural factors and how each individual interprets violence in various communities. In addition, it should be noted several cases of violence goes unreported.
Many factors are reported to affect the increased occurrence of violence following catastrophes. For instance, such events may cause reduced marital satisfaction and increased aggressive behaviors, leading to declined intimacy. In addition, stressful events following a catastrophe result in economic disruption or uncertainty, or psychological disorder, leading to an increased prevalence of aggressive behaviors of the partner. Furthermore, access to external support, including family members and friends, or professional services, which are highly useful for victim women, is often declined [31, 32]. Therefore, measures are needed to address the negative consequences of quarantine and stay-at-home policies.
Few studies investigated the prevalence of social violence during the COVID-19 outbreak in Iran. On the other hand, in some countries, including Australia, a considerable decline in social violence, such as sexual abuse and quarrel, is reported following the stay-at-home policy compared to the previous year . Meanwhile, the rate of domestic violence did not change. Similar results are reported in Sweden and USA [18, 33]. Nevertheless, a study reported a slight increase in vehicle theft during the COVID-19 outbreak . In the same vein, the findings of this study also indicated a lower prevalence of social violence than domestic violence. There was a significant association between COVID-19 infection and domestic and social violence. COVID-19 infection and its social stigma may pave the way for domestic and social violence , indicating the necessity of increased attention from planners and health policymakers.
Following a population-based design and selecting a high number of subjects using a random sampling technique are among the strengths of this study. In addition, the prevalence of violence in both sexes is considered. Last but not least, participants are selected from all provinces of the country.
In this study, data are collected using the self-report method by telephone interview. Also, only physical and verbal dimensions of violence are investigated. Regarding the importance of other dimensions of violence, including physical and mental, and its severe consequences, particularly during the COVID-19 outbreak, caution should be taken when generalizing the results.