 |
|
Mental Health Symptoms Following War and Repression in Eastern Afghanistan
Willem F. Scholte, MD;
Miranda Olff, PhD;
Peter Ventevogel, MD;
Giel-Jan de Vries, MA, MSc;
Eveline Jansveld, MA;
Barbara Lopes Cardozo, MD, MPH;
Carol A. Gotway Crawford, PhD
JAMA. 2004;292:585-593.
Context Decades of armed conflict, suppression, and displacement resulted in a high prevalence of mental health symptoms throughout Afghanistan. Its Eastern province of Nangarhar is part of the region that originated the Taliban movement. This may have had a distinct impact on the living circumstances and mental health condition of the province's population.
Objectives To determine the rate of exposure to traumatic events; estimate prevalence rates of symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety; identify resources used for emotional support and risk factors for mental health symptoms; and assess the present coverage of basic needs in Nangarhar province, Afghanistan.
Design, Setting, and Participants A cross-sectional multicluster sample survey of 1011 respondents aged 15 years or older, conducted in Nangarhar province during January and March 2003; 362 households were represented with a mean of 2.8 respondents per household (72% participation rate).
Main Outcome Measures Posttraumatic stress disorder symptoms and traumatic events using the Harvard Trauma Questionnaire; depression and general anxiety symptoms using the Hopkins Symptom Checklist; and resources for emotional support through a locally informed questionnaire.
Results During the past 10 years, 432 respondents (43.7%) experienced between 8 and 10 traumatic events; 141 respondents (14.1%) experienced 11 or more. High rates of symptoms of depression were reported by 391 respondents (38.5%); anxiety, 524 (51.8%); and PTSD, 207 (20.4%). Symptoms were more prevalent in women than in men (depression: odds ratio [OR], 7.3 [95% confidence interval {CI}, 5.4-9.8]; anxiety: OR, 12.8 [95% CI, 9.0-18.1]; PTSD: OR, 5.8 [95% CI, 3.8-8.9]). Higher rates of symptoms were associated with higher numbers of traumas experienced. The main resources for emotional support were religion and family. Medical care was reported to be insufficient by 228 respondents (22.6%).
Conclusions In this survey of inhabitants of Nangarhar province, Afghanistan, prevalence rates of having experienced multiple traumatic events and having symptoms of anxiety, depression, and PTSD were high. These findings suggest that mental health symptoms in this region should be addressed at the population and primary health care level.
Author Affiliations: Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands (Drs Scholte, Olff, and Ventevogel and Mr de Vries and Ms Jansveld); HealthNet International, Amsterdam, the Netherlands (Dr Ventevogel); War Child, Amsterdam, the Netherlands (Ms Jansveld); and International Emergency and Refugee Health Branch, Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga (Drs Lopes Cardozo and Gotway Crawford).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLES
Mental Health, Social Functioning, and Disability in Postwar Afghanistan
Barbara Lopes Cardozo, Oleg O. Bilukha, Carol A. Gotway Crawford, Irshad Shaikh, Mitchell I. Wolfe, Michael L. Gerber, and Mark Anderson
JAMA. 2004;292(5):575-584.
ABSTRACT
| FULL TEXT
Mental Health in Postwar Afghanistan
Paul Bolton and Theresa Stichick Betancourt
JAMA. 2004;292(5):626-628.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
The Validity and Clinical Utility of Post-traumatic Stress Disorder in Afghanistan
Miller et al.
Transcultural Psychiatry 2009;46:219-237.
ABSTRACT
Daily Stressors, War Experiences, and Mental Health in Afghanistan
Miller et al.
Transcultural Psychiatry 2008;45:611-638.
ABSTRACT
Population-based survey methods to quantify associations between human rights violations and health outcomes among internally displaced persons in eastern Burma
Mullany et al.
J. Epidemiol. Community Health 2007;61:908-914.
ABSTRACT
| FULL TEXT
Prevalence of Posttraumatic Stress Disorder in a Coastal Fishing Village in Tamil Nadu, India, After the December 2004 Tsunami
Kumar et al.
AJPH 2007;97:99-101.
ABSTRACT
| FULL TEXT
Life stress and depression in a tribal area of Pakistan
HUSAIN et al.
Br. J. Psychiatry 2007;190:36-41.
ABSTRACT
| FULL TEXT
Anxiety, depression, and posttraumatic stress in Iranian survivors of chemical warfare.
Hashemian et al.
JAMA 2006;296:560-566.
ABSTRACT
| FULL TEXT
Mental Health of Cambodian Refugees 2 Decades After Resettlement in the United States
Marshall et al.
JAMA 2005;294:571-579.
ABSTRACT
| FULL TEXT
Mental Health in Postwar Afghanistan
Bolton and Betancourt
JAMA 2004;292:626-628.
FULL TEXT
|
