V Kovess-Masfety1,2,3, Katherine Keyes4, Elie Karam5,6, Ajmal Sabawoon7,8, Bashir Ahmad Sarwari9. 1. Conseil Santé, Clichy, France. 2. Department of Psychiatry, McGill University, Montreal, Canada. 3. Université de Paris, LPPS, Boulogne-Billancourt, France. 4. Mailman School of Public Health, Columbia University, New York, NY, USA. 5. Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon. 6. Dept. of Psychiatry & Clinical Psychology, St. George Hospital University Medical Center University of Balamand, Faculty of Medicine, Beirut, Lebanon. 7. Governance Institute of Afghanistan (GI-A), Kabul, Afghanistan. sabawoonajmal@gmail.com. 8. Kabul University of Medical Sciences (KUMS), Kabul, Afghanistan. sabawoonajmal@gmail.com. 9. Dept of Mental Health & Substance Abuse, Primary Health Care Directorate, Ministry of Public Health, Kabul, Afghanistan.
Abstract
BACKGROUND: This survey attempts to measure at a national level, exposures to major traumas and the prevalence of common mental health disorders in a low-income dangerous country, highly affected by conflicts: Afghanistan. METHODS: Trans-sectional probability survey in general population by multistage sampling in 8 provinces, represented nationwide: 4445 adults (4433 weighted),15 years or older, 81% participation rate. Face to face interviews used specific scales for measuring lifetime exposure (LEC 5 Life Events Checklist) and Post Traumatic Stress Disorder (PTSD Check List), a diagnostic standardized interview: Composite International Diagnostic Interview (Short Form) for. Major Depressive Episode and Generalized Anxiety Disorder, plus scales for suicidal thoughts and attempts and psychological distress (MH5 and RE from SF36). RESULTS: 52.62% of the population is illiterate, 84,61% of the women do not have any source of income; 70.92% of the population lives in rural areas, 60.62% are below 35 years, 80% lives in very dangerous areas. 64.67% of the Afghan population had personally experienced at least one traumatic event; 78.48% had witnessed one such event. 60.77% of the sample experienced collective violence in relation to war and 48.76% reported four or more events; this very much differs across regions and levels of danger; women are less at risk for trauma except sexual violence, 35 years and above are more at risk than younger. 12-month PTSD prevalence reaches a high rate: 5.34% as MDE 11,71%, whereas GAD 2.78%; suicidal thoughts 2.26%, lifetime suicidal attempts 3.50% are close to reported in other countries. Women have more risk for PTSD (0R = 1.93) and suicidal behaviours (attempts OR = 1.92) than men; the number of events increases risk for MDE, PTSD and suicidal attempts, whereas education is protective. Exposure to different war events produced different mental health effects. People suffering from PTSD have higher risk to report 12-months suicidal ideations and lifetime suicidal attempts. CONCLUSION: Our findings highlight the need to map the extent and the types of mental disorders post conflict; this would help maximise the help to be offered in guiding proper choice of interventions, including education.
BACKGROUND: This survey attempts to measure at a national level, exposures to major traumas and the prevalence of common mental health disorders in a low-income dangerous country, highly affected by conflicts: Afghanistan. METHODS: Trans-sectional probability survey in general population by multistage sampling in 8 provinces, represented nationwide: 4445 adults (4433 weighted),15 years or older, 81% participation rate. Face to face interviews used specific scales for measuring lifetime exposure (LEC 5 Life Events Checklist) and Post Traumatic Stress Disorder (PTSD Check List), a diagnostic standardized interview: Composite International Diagnostic Interview (Short Form) for. Major Depressive Episode and Generalized Anxiety Disorder, plus scales for suicidal thoughts and attempts and psychological distress (MH5 and RE from SF36). RESULTS: 52.62% of the population is illiterate, 84,61% of the women do not have any source of income; 70.92% of the population lives in rural areas, 60.62% are below 35 years, 80% lives in very dangerous areas. 64.67% of the Afghan population had personally experienced at least one traumatic event; 78.48% had witnessed one such event. 60.77% of the sample experienced collective violence in relation to war and 48.76% reported four or more events; this very much differs across regions and levels of danger; women are less at risk for trauma except sexual violence, 35 years and above are more at risk than younger. 12-month PTSD prevalence reaches a high rate: 5.34% as MDE 11,71%, whereas GAD 2.78%; suicidal thoughts 2.26%, lifetime suicidal attempts 3.50% are close to reported in other countries. Women have more risk for PTSD (0R = 1.93) and suicidal behaviours (attempts OR = 1.92) than men; the number of events increases risk for MDE, PTSD and suicidal attempts, whereas education is protective. Exposure to different war events produced different mental health effects. People suffering from PTSD have higher risk to report 12-months suicidal ideations and lifetime suicidal attempts. CONCLUSION: Our findings highlight the need to map the extent and the types of mental disorders post conflict; this would help maximise the help to be offered in guiding proper choice of interventions, including education.
Authors: C Benjet; E Bromet; E G Karam; R C Kessler; K A McLaughlin; A M Ruscio; V Shahly; D J Stein; M Petukhova; E Hill; J Alonso; L Atwoli; B Bunting; R Bruffaerts; J M Caldas-de-Almeida; G de Girolamo; S Florescu; O Gureje; Y Huang; J P Lepine; N Kawakami; Viviane Kovess-Masfety; M E Medina-Mora; F Navarro-Mateu; M Piazza; J Posada-Villa; K M Scott; A Shalev; T Slade; M ten Have; Y Torres; M C Viana; Z Zarkov; K C Koenen Journal: Psychol Med Date: 2015-10-29 Impact factor: 7.723
Authors: Josep Maria Haro; Saena Arbabzadeh-Bouchez; Traolach S Brugha; Giovanni de Girolamo; Margaret E Guyer; Robert Jin; Jean Pierre Lepine; Fausto Mazzi; Blanca Reneses; Gemma Vilagut; Nancy A Sampson; Ronald C Kessler Journal: Int J Methods Psychiatr Res Date: 2006 Impact factor: 4.035
Authors: Barbara Lopes Cardozo; Oleg O Bilukha; Carol A Gotway Crawford; Irshad Shaikh; Mitchell I Wolfe; Michael L Gerber; Mark Anderson Journal: JAMA Date: 2004-08-04 Impact factor: 56.272
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: Elie G Karam; Matthew J Friedman; Eric D Hill; Ronald C Kessler; Katie A McLaughlin; Maria Petukhova; Laura Sampson; Victoria Shahly; Matthias C Angermeyer; Evelyn J Bromet; Giovanni de Girolamo; Ron de Graaf; Koen Demyttenaere; Finola Ferry; Silvia E Florescu; Josep Maria Haro; Yanling He; Aimee N Karam; Norito Kawakami; Viviane Kovess-Masfety; María Elena Medina-Mora; Mark A Oakley Browne; José A Posada-Villa; Arieh Y Shalev; Dan J Stein; Maria Carmen Viana; Zahari Zarkov; Karestan C Koenen Journal: Depress Anxiety Date: 2013-08-27 Impact factor: 6.505
Authors: Peter Ventevogel; Willem van de Put; Hafizullah Faiz; Bibiane van Mierlo; Majeed Siddiqi; Ivan H Komproe Journal: PLoS Med Date: 2012-05-29 Impact factor: 11.069