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Political violence and mental health in Nepal: prospective study.

Publication ,  Journal Article
Kohrt, BA; Hruschka, DJ; Worthman, CM; Kunz, RD; Baldwin, JL; Upadhaya, N; Acharya, NR; Koirala, S; Thapa, SB; Tol, WA; Jordans, MJD ...
Published in: Br J Psychiatry
October 2012

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.

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Published In

Br J Psychiatry

DOI

EISSN

1472-1465

Publication Date

October 2012

Volume

201

Issue

4

Start / End Page

268 / 275

Location

England

Related Subject Headings

  • Violence
  • Stress Disorders, Post-Traumatic
  • Risk Factors
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Prospective Studies
  • Poverty
  • Politics
  • Nepal
  • Middle Aged
 

Citation

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Kohrt, B. A., Hruschka, D. J., Worthman, C. M., Kunz, R. D., Baldwin, J. L., Upadhaya, N., … Nepal, M. K. (2012). Political violence and mental health in Nepal: prospective study. Br J Psychiatry, 201(4), 268–275. https://doi.org/10.1192/bjp.bp.111.096222
Kohrt, Brandon A., Daniel J. Hruschka, Carol M. Worthman, Richard D. Kunz, Jennifer L. Baldwin, Nawaraj Upadhaya, Nanda Raj Acharya, et al. “Political violence and mental health in Nepal: prospective study.Br J Psychiatry 201, no. 4 (October 2012): 268–75. https://doi.org/10.1192/bjp.bp.111.096222.
Kohrt BA, Hruschka DJ, Worthman CM, Kunz RD, Baldwin JL, Upadhaya N, et al. Political violence and mental health in Nepal: prospective study. Br J Psychiatry. 2012 Oct;201(4):268–75.
Kohrt, Brandon A., et al. “Political violence and mental health in Nepal: prospective study.Br J Psychiatry, vol. 201, no. 4, Oct. 2012, pp. 268–75. Pubmed, doi:10.1192/bjp.bp.111.096222.
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. Political violence and mental health in Nepal: prospective study. Br J Psychiatry. 2012 Oct;201(4):268–275.
Journal cover image

Published In

Br J Psychiatry

DOI

EISSN

1472-1465

Publication Date

October 2012

Volume

201

Issue

4

Start / End Page

268 / 275

Location

England

Related Subject Headings

  • Violence
  • Stress Disorders, Post-Traumatic
  • Risk Factors
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Prospective Studies
  • Poverty
  • Politics
  • Nepal
  • Middle Aged