Political violence and mental health in Nepal: prospective study.

Journal Article (Journal Article)

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.

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

  • PMC3461445

Electronic International Standard Serial Number (EISSN)

  • 1472-1465

Digital Object Identifier (DOI)

  • 10.1192/bjp.bp.111.096222


  • eng

Conference Location

  • England