Victor D Puac-Polanco1, Victor A Lopez-Soto, Robert Kohn, Dawei Xie, Therese S Richmond, Charles C Branas. 1. Victor D. Puac-Polanco is with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Victor A. Lopez-Soto is with the Universidad de San Carlos de Guatemala Facultad de Medicina, Guatemala City. Robert Kohn is with the Department of Psychiatry and Human Behavior, Brown University, Providence, RI. Dawei Xie and Charles C. Branas are with the Department of Biostatistics and Epidemiology, School of Medicine, University of Pennsylvania, Philadelphia. Therese S. Richmond is with the School of Nursing, University of Pennsylvania, Philadelphia.
Abstract
OBJECTIVES: We analyzed a probability sample of Guatemalans to determine if a relationship exists between previous violent events and development of mental health outcomes in various sociodemographic groups, as well as during and after the Guatemalan Civil War. METHODS: We used regression modeling, an interaction test, and complex survey design adjustments to estimate prevalences and test potential relationships between previous violent events and mental health. RESULTS: Many (20.6%) participants experienced at least 1 previous serious violent event. Witnessing someone severely injured or killed was the most common event. Depression was experienced by 4.2% of participants, with 6.5% experiencing anxiety, 6.4% an alcohol-related disorder, and 1.9% posttraumatic stress disorder (PTSD). Persons who experienced violence during the war had 4.3 times the adjusted odds of alcohol-related disorders (P < .05) and 4.0 times the adjusted odds of PTSD (P < .05) compared with the postwar period. Women, indigenous Maya, and urban dwellers had greater odds of experiencing postviolence mental health outcomes. CONCLUSIONS: Violence that began during the civil war and continues today has had a significant effect on the mental health of Guatemalans. However, mental health outcomes resulting from violent events decreased in the postwar period, suggesting a nation in recovery.
OBJECTIVES: We analyzed a probability sample of Guatemalans to determine if a relationship exists between previous violent events and development of mental health outcomes in various sociodemographic groups, as well as during and after the Guatemalan Civil War. METHODS: We used regression modeling, an interaction test, and complex survey design adjustments to estimate prevalences and test potential relationships between previous violent events and mental health. RESULTS: Many (20.6%) participants experienced at least 1 previous serious violent event. Witnessing someone severely injured or killed was the most common event. Depression was experienced by 4.2% of participants, with 6.5% experiencing anxiety, 6.4% an alcohol-related disorder, and 1.9% posttraumatic stress disorder (PTSD). Persons who experienced violence during the war had 4.3 times the adjusted odds of alcohol-related disorders (P < .05) and 4.0 times the adjusted odds of PTSD (P < .05) compared with the postwar period. Women, indigenous Maya, and urban dwellers had greater odds of experiencing postviolence mental health outcomes. CONCLUSIONS: Violence that began during the civil war and continues today has had a significant effect on the mental health of Guatemalans. However, mental health outcomes resulting from violent events decreased in the postwar period, suggesting a nation in recovery.
Authors: Laura Andrade; Jorge J Caraveo-Anduaga; Patricia Berglund; Rob V Bijl; Ron De Graaf; Wilma Vollebergh; Eva Dragomirecka; Robert Kohn; Martin Keller; Ronald C Kessler; Norito Kawakami; Cengiz Kiliç; David Offord; T Bedirhan Ustun; Hans-Ulrich Wittchen Journal: Int J Methods Psychiatr Res Date: 2003 Impact factor: 4.035
Authors: Willem F Scholte; Miranda Olff; Peter Ventevogel; Giel-Jan de Vries; Eveline Jansveld; Barbara Lopes Cardozo; Carol A Gotway Crawford Journal: JAMA Date: 2004-08-04 Impact factor: 56.272
Authors: Koen Demyttenaere; Ronny Bruffaerts; Jose Posada-Villa; Isabelle Gasquet; Viviane Kovess; Jean Pierre Lepine; Matthias C Angermeyer; Sebastian Bernert; Giovanni de Girolamo; Pierluigi Morosini; Gabriella Polidori; Takehiko Kikkawa; Norito Kawakami; Yutaka Ono; Tadashi Takeshima; Hidenori Uda; Elie G Karam; John A Fayyad; Aimee N Karam; Zeina N Mneimneh; Maria Elena Medina-Mora; Guilherme Borges; Carmen Lara; Ron de Graaf; Johan Ormel; Oye Gureje; Yucun Shen; Yueqin Huang; Mingyuan Zhang; Jordi Alonso; Josep Maria Haro; Gemma Vilagut; Evelyn J Bromet; Semyon Gluzman; Charles Webb; Ronald C Kessler; Kathleen R Merikangas; James C Anthony; Michael R Von Korff; Philip S Wang; Traolach S Brugha; Sergio Aguilar-Gaxiola; Sing Lee; Steven Heeringa; Beth-Ellen Pennell; Alan M Zaslavsky; T Bedirhan Ustun; Somnath Chatterji Journal: JAMA Date: 2004-06-02 Impact factor: 56.272
Authors: Dorian E Ramírez; Charles C Branas; Therese S Richmond; Kent Bream; Dawei Xie; Magda Velásquez-Tohom; Douglas J Wiebe Journal: Inj Prev Date: 2016-10-03 Impact factor: 2.399
Authors: Maria Alejandra Paniagua-Avila; Elizabeth Messenger; Caroline A Nelson; Erwin Calgua; Frances K Barg; Kent W Bream; Charlene Compher; Anthony J Dean; Sergio Martinez-Siekavizza; Victor Puac-Polanco; Therese S Richmond; Rudolf R Roth; Charles C Branas Journal: Front Public Health Date: 2017-04-10
Authors: Robert Kohn; Ali Ahsan Ali; Victor Puac-Polanco; Chantal Figueroa; Victor López-Soto; Kristen Morgan; Sandra Saldivia; Benjamín Vicente Journal: Rev Panam Salud Publica Date: 2018-10-10
Authors: Christina Mair; Jessica Frankeberger; Paul J Gruenewald; Christopher N Morrison; Bridget Freisthler Journal: Curr Epidemiol Rep Date: 2019-09-13