Political violence and mental health in Nepal: prospective study.

Published

Journal Article

Post-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence.This prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal.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.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.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.

Full Text

Duke Authors

Cited Authors

  • Kohrt, BA; Hruschka, DJ; Worthman, CM; Kunz, RD; Baldwin, JL; Upadhaya, N; Acharya, NR; Koirala, S; Thapa, SB; Tol, WA; Jordans, MJD; Robkin, N; Sharma, VD; Nepal, MK

Published Date

  • October 2012

Published In

Volume / Issue

  • 201 / 4

Start / End Page

  • 268 - 275

PubMed ID

  • 22878131

Pubmed Central ID

  • 22878131

Electronic International Standard Serial Number (EISSN)

  • 1472-1465

International Standard Serial Number (ISSN)

  • 0007-1250

Digital Object Identifier (DOI)

  • 10.1192/bjp.bp.111.096222

Language

  • eng