Associations of Women’s Empowerment and Intimate Partner Violence with Mental Health Among Ever-Married Women in Bangladesh

Objective This paper examines the associations between women's empowerment, IPV legitimization, and the mental health outcomes of Bangladeshi ever-married women with geospatial variation. Methods This study analyzed cross-sectional data from the Bangladesh Demographic and Health Survey 2022 of 18,987 ever-married women aged 15–49 years with complete mental health, IPV, and empowerment data. Depression and anxiety were assessed by PHQ-9 and GAD-7. Survey-weighted binary logistic regression analyses were applied to analyze odds ratios (ORs) and 95% confidence intervals (CIs), with stratification by residence, wealth, and religion. Results Women who justified IPV had marginally higher depression (5.5% vs 4.7%) and anxiety (4.9% vs 4.0%) prevalence, whereas empowerment was associated with marginally higher anxiety (4.4% vs 3.0%) but not depression. Multivariable analyses further revealed that empowerment was independently associated with anxiety (aOR 1.39, 95% CI 1.14–1.70, p = 0.001), but IPV justification was not significant in the adjusted model. Multiparity, age, pressure to conceive, and improved education of fathers and women were also important determinants. Division -wise geospatial mapping revealed the highest rates of anxiety in Khulna (37.9%), Rangpur (37.4%), and Barisal (37.1%), and the lowest in Rajshahi (35.2%) and Dhaka (35.9%). Additionally, Rangpur (38.6%) and Khulna (38.6%) reveal the highest depression symptoms. Conclusions These findings highlight the mental health implications of empowerment and the need for context-specific policies to support women's mental health in Bangladesh.