Persons displaced by war at increased risk of posttraumatic stress disorder, depression, anxiety

August 2, 2011 in Psychology & Psychiatry

Residents of Sri Lanka who were internally displaced during the civil conflict that occurred in their country from 1983 to 2009 have a higher prevalence of war-related mental health conditions that include depression, anxiety and posttraumatic stress disorder, according to a study in the August 3 issue of JAMA, a theme issue on violence and human rights.

Armed conflicts may result in displacement of persons seeking refuge in neighboring countries or secure areas of their own country (internal displacement). "Nearly 2.7 million individuals worldwide are internally displaced annually by armed conflict. The Sri Lankan conflict resulted in approximately 100,000 deaths and displacement of 800,000 people during the 26-year war," according to background information in the article. In the Jaffna District of Sri Lanka, a peninsula in the far north of the country, it has been estimated that 23 percent of the population had been internally displaced by July 2009. "Although overall patterns of psychiatric morbidity among conflict-affected populations have been documented, less is known about the psychological effect of forced displacement among individuals who remain within their national borders."

Farah Husain, D.M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a health survey among residents of Jaffna District to assess the association between displacement status and the prevalence of common war-related . The survey was conducted between July and September 2009 among 1,517 Jaffna District households, including 2 internally displaced persons camps. The response rate was 92 percent (1,448 respondents, 1,409 eligible respondents). Two percent of participants (n = 80) were currently displaced, 29.5 percent (n = 539) were recently resettled, and 68.5 percent (n = 790) were long-term residents. A total of 376 (31.8 percent) participants experienced no trauma events; 578 (44.0 percent) reported experiencing 1 to 4 events; 336 (20.2 percent) experienced 5 to 9 events; and 72 (4.0 percent) experienced 10 or more events.

The overall prevalences of posttraumatic stress disorder (PTSD), anxiety, and depression symptoms were 7.0 percent, 32.6 percent, and 22.2 percent, respectively. After adjusting for variables, the researchers found that the odds of having symptoms of depression, anxiety, and PTSD were significantly higher among displaced camp-based individuals compared with long-term residents and that the odds of reporting PTSD symptoms among recently resettled participants was higher than that of long-term residents. Female respondents were more likely to report symptoms of anxiety and depression. Older age was associated with PTSD, anxiety, and depression symptoms. The authors also found that displacement was no longer associated with symptoms after controlling for trauma exposure.

"Although the association between displacement status and symptoms of PTSD, depression, and anxiety was no longer significant after adjusting for trauma exposure in this study, the act of being displaced and the daily stressors associated with it may be considered traumatic in themselves and may be an indicator or proxy for recent trauma as well. Therefore, the relationship between displacement status and mental health symptoms may be driven by the underlying trauma events displaced persons have experienced, events that likely caused them to leave their homes," they write.

The researchers suggest that interventions in Sri Lanka should target the most vulnerable populations, especially those living in displacement camps. "Internally displaced persons outnumber refugees globally and initiatives addressing mental health needs, such as those developed by the Inter-Agency Standing Committee, should be considered. In Jaffna District, interventions should include support from family, friends, religious leaders, and traditional counselors. Finally, a longitudinal study of displaced populations would help determine how the intensity of events, the time since events, and other factors, such as coping skills, affect mental health symptoms. In this way, stakeholders could begin to understand the short- and long-term mental health implications of armed conflict and traumatic events associated with displacement."

More information: JAMA. 2011;306[5]:522-531

Provided by JAMA and Archives Journals search and more info website

not rated yet  

Rank not rated yet
Relevant PhysicsForums posts

More news stories

US psychiatry gets makeover in new manual

The latest makeover to a massive psychiatric tome honored by some, reviled by others and even called the "Bible" of mental disorders is being released Saturday with a host of new changes.

Psychology & Psychiatry created 2 hours ago | popularity not rated yet | comments 0

Study reviews readmissions in inpatient psychiatric facilities

(HealthDay)—Most Medicare beneficiaries treated in inpatient psychiatric facilities (IPFs) exhibit characteristics associated with hospital readmission, according to a report prepared for the National Association ...

Psychology & Psychiatry created May 17, 2013 | popularity not rated yet | comments 0

Skydiving is never plane sailing

Skydivers show the same level of physical stress before every jump whether a first-timer or experienced jumper, say Northumbria researchers.

Psychology & Psychiatry created May 17, 2013 | popularity not rated yet | comments 0 | with audio podcast

Kids, especially boys, perceive sadness of depressed parents

Children of depressed parents pick up on their parents' sadness—whether mom or dad realizes their mood or not.

Psychology & Psychiatry created May 17, 2013 | popularity 4.5 / 5 (2) | comments 1 | with audio podcast

One in five U.S. kids has a mental health disorder, CDC reports

(HealthDay)—As many as one in five American children under the age of 17 has a diagnosable mental disorder in a given year, according to a new federal report.

Psychology & Psychiatry created May 16, 2013 | popularity 2.2 / 5 (5) | comments 1 | with audio podcast


New research identifies risks, interventions for children's GI health

An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).

New case of SARS-like virus in Saudi: ministry

A new case of the deadly coronavirus has been detected in Saudi Arabia where 15 people have already died after contracting it, the health ministry announced on Saturday on its Internet website.

AIDS science at 30: 'Cure' now part of lexicon

Big names in medicine are set to give an upbeat assessment of the war on AIDS on Tuesday, 30 years after French researchers identified the virus that causes the disease.

For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests

Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or ...

New colonoscope provides ground-breaking view of colon

A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...

Now we know why old scizophrenia medicine works on antibiotics-resistant bacteria

In 2008 researchers from the University of Southern Denmark showed that the drug thioridazine, which has previously been used to treat schizophrenia, is also a powerful weapon against antibiotic-resistant bacteria such as ...