BACKGROUND: Post-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence. AIMS: This prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal. METHOD: An adult cohort completed the Beck Depression Inventory and Beck Anxiety Inventory in 2000 prior to conflict violence in their community and in 2007 after the war. RESULTS: Of the original 316 participants, 298 (94%) participated in the post-conflict assessment. Depression increased from 30.9 to 40.6%. Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stress disorder (PTSD) was 14.1%. Controlling for ageing, the depression increase was not significant. The anxiety increase showed a dose-response association with conflict exposure when controlling for ageing and daily stressors. No demographic group displayed unique vulnerability or resilience to the effects of conflict exposure. CONCLUSIONS: Conflict exposure should be considered in the context of other types of psychiatric risk factors. Conflict exposure predicted increases in anxiety whereas socioeconomic factors and non-conflict stressful life events were the major predictors of depression. Research and interventions in post-conflict settings therefore should consider differential trajectories for depression v. anxiety and the importance of addressing chronic social problems ranging from poverty to gender and ethnic/caste discrimination.
BACKGROUND: Post-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence. AIMS: This prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal. METHOD: An adult cohort completed the Beck Depression Inventory and Beck Anxiety Inventory in 2000 prior to conflict violence in their community and in 2007 after the war. RESULTS: Of the original 316 participants, 298 (94%) participated in the post-conflict assessment. Depression increased from 30.9 to 40.6%. Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stress disorder (PTSD) was 14.1%. Controlling for ageing, the depression increase was not significant. The anxiety increase showed a dose-response association with conflict exposure when controlling for ageing and daily stressors. No demographic group displayed unique vulnerability or resilience to the effects of conflict exposure. CONCLUSIONS: Conflict exposure should be considered in the context of other types of psychiatric risk factors. Conflict exposure predicted increases in anxiety whereas socioeconomic factors and non-conflict stressful life events were the major predictors of depression. Research and interventions in post-conflict settings therefore should consider differential trajectories for depression v. anxiety and the importance of addressing chronic social problems ranging from poverty to gender and ethnic/caste discrimination.
Authors: Wietse A Tol; Brandon A Kohrt; Mark J D Jordans; Suraj B Thapa; Judith Pettigrew; Nawaraj Upadhaya; Joop T V M de Jong Journal: Soc Sci Med Date: 2009-10-14 Impact factor: 4.634
Authors: Brandon A Kohrt; Rebecca A Speckman; Richard D Kunz; Jennifer L Baldwin; Nawaraj Upadhaya; Nanda Raj Acharya; Vidya Dev Sharma; Mahendra K Nepal; Carol M Worthman Journal: Ann Hum Biol Date: 2009 May-Jun Impact factor: 1.533
Authors: Wietse A Tol; Ivan H Komproe; Suraj B Thapa; Mark J D Jordans; Bhogendra Sharma; Joop T V M De Jong Journal: J Nerv Ment Dis Date: 2007-06 Impact factor: 2.254
Authors: Nagendra P Luitel; Mark J D Jordans; Ram P Sapkota; Wietse A Tol; Brandon A Kohrt; Suraj B Thapa; Ivan H Komproe; Bhogendra Sharma Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2012-07-10 Impact factor: 4.328
Authors: Brandon A Kohrt; Mark J D Jordans; Sauharda Rai; Pragya Shrestha; Nagendra P Luitel; Megan K Ramaiya; Daisy R Singla; Vikram Patel Journal: Behav Res Ther Date: 2015-03-24
Authors: Brandon A Kohrt; Carol M Worthman; Kerry J Ressler; Kristina B Mercer; Nawaraj Upadhaya; Suraj Koirala; Mahendra K Nepal; Vidya Dev Sharma; Elisabeth B Binder Journal: Int Rev Psychiatry Date: 2015-06-23
Authors: William G Axinn; Yang Zhang; Dirgha J Ghimire; Stephanie A Chardoul; Kate M Scott; Ronny Bruffaerts Journal: J Affect Disord Date: 2020-01-15 Impact factor: 4.839
Authors: Theresa S Betancourt; Ivelina Borisova; Timothy P Williams; Sarah E Meyers-Ohki; Julia E Rubin-Smith; Jeannie Annan; Brandon A Kohrt Journal: J Child Psychol Psychiatry Date: 2012-10-12 Impact factor: 8.982
Authors: Mark J D Jordans; Brandon A Kohrt; Nagendra P Luitel; Ivan H Komproe; Crick Lund Journal: Br J Psychiatry Date: 2015-10-08 Impact factor: 9.319