Clustering of symptoms of mental disorder in the medium-term following conflict: an epidemiological study in Timor-Leste.

It is important to define subpopulations with mental health and psychosocial reactions in the medium-term following conflict to ensure that an appropriate array of services are provided to meet the diversity of needs. We conducted a latent class analysis (LCA) on epidemiological data drawn from an urban and rural sample of 1221 adults (581 men and 640 women, response 82%) in post-conflict Timor Leste 4 years after the cessation of violence. The prevalence of PTSD was 4.9%; severe distress 4.8%; anger attacks 38.3%; and paranoid-like symptoms 10.9%. The best fitting LCA yielded three classes comprising those with no or minimal symptoms (86%), a class with anger-paranoia (13%) and a comorbid mental disorder class (1.5%) characterized by PTSD (100%) and severe distress (98%). The comorbid mental disorder class had an over-representation of men, the unemployed, residents in the urban area and persons with the greatest exposure to human rights trauma, murder and health stress. The anger-paranoia class experienced moderate levels of trauma and had an over-representation of urban dwellers, women, and those with higher levels of education. The analysis assists in clarifying the populations with mental disorder and adverse psychosocial reactions in need of intervention in the medium-term following conflict.