Prevalence and factors associated with Posttraumatic Stress Disorder seven years after the conflict in three districts in northern Uganda (The Wayo-Nero Study)

Abstract

BackgroundResearch on the prevalence of Posttraumatic Stress Disorder (PTSD) is still limited in low income countries yet PTSD can be a public health problem in post conflict areas. In order to respond to the burden of PSTD in northern Uganda, an area that experienced civil strife for over two decades, we need accurate data on its (PTSD) prevalence and the associated risk factors to facilitate public mental health planning.MethodsThis study employed a cross-sectional study design and data collection was undertaken in three districts in northern Uganda: Gulu, Amuru and Nwoya. Respondents were aged 18 years and above and were randomly selected at community level. A total of 2400 respondents were interviewed using a structured questionnaire in the three study districts. In this study, multivariate logistic regression was employed to analyze the associations of socio-demographic factors, trauma related variables and the outcome of PTSD.ResultsThe prevalence of Posttraumatic Stress Disorder (PTSD) in the study population was 11.8 % (95 % CI: 10.5 %, 13.1 %) with a prevalence of 10.9 % (95 % CI: 9.3 %, 12.5 %) among female respondents and 13.4 % (95 % CI: 11.2 %, 15.7 %) among male respondents. Quite a number of factors were strongly associated with PTSD. Overall, a respondent had experienced 9 negative life events. In a multivariate logistic regression, the factors that were strongly associated with PTSD were: exposure to war trauma events, childhood trauma, negative life events, negative copying style and food insecurity. The findings also indicate no association between sex, age and PTSD.ConclusionThe prevalence rate of PTSD in the study communities is unacceptably high. Quite a number of factors were associated with PTSD. Effective public mental health services are needed that combine treatment (medical) psychological and social welfare programs especially at community level to address the high burden of PTSD. Longitudinal studies are also recommended to continuously assess the trends in PTSD in the study communities and remedial action taken.

Prevalence of suicidal ideation and attempt: associations with psychiatric disorders and HIV/AIDS in post-conflict Northern Uganda

“…More in detail, suicide ideation was reported in 12.4 % and a suicide attempt in 17,1% of patients attending a specialized HIV/AIDS clinic before the antiretroviral treatment (ART) era in Uganda; while the suicidal ideation rate was 13 % in the same setting in post-ART Uganda (Kinyanda et al, 2015). The reason for these higher rates could be explained by differences in location.…”

“…Previous studies have indicated comorbidity between suicidality and psychiatric disorders, in particular with depression and PTSD (Wasserman et al, 1999;Ovuga et al, 2005;Kiyanda et al, 2015;Casey et al, 2006;Nock et al, 2008), though few studies have used formal diagnostic criteria (Wasserman et al, 1999) as in the current study. The high prevalence of major depressive disorder (at a rate of 24.7 %; Mugisha et al 2015) and PTSD (at a rate of 11.8 %, Mugisha et al, 2015) could explain the high rates of suicide attempt and ideation.…”

“…However, this strategic plan should have a strong component that entails effective management of the co-morbid conditions highlighted above and HIV/AIDS (Mugisha et al, 2015). A specific and well-tailored suicide prevention strategy and action plan for post-conflict Northern Uganda is vital as it has been done in some countries where some sections of the population have been more vulnerable to suicidal behavior (Corcoran et al, 2015).…”

“…The reason for these higher rates could be explained by differences in location. The study of Kinyanda et al (2015) was conducted in urban Uganda while the present study took place in rural populations in Northern Uganda. Greater openness about suicidality was found previously in urban compared to rural populations (Mugisha, 2012, Ovuga et al, 2005.…”

Food Insecurity and Risk of Depression Among Refugees and Immigrants in South Africa

“…The health and nutrition status of refugees represents a major public health concern, and to the best of our knowledge, this is the first study to examine the relationship between food security and common mental disorders in a refugee population in South Africa; although previous studies have found evidence for such a relationship within conflict-affected and internally displaced populations in other low- and middle-income countries (LMICs), such as Uganda [21] and Sri Lanka [22]. The results indicate a high prevalence of food insecurity in this population in South Africa; and that food insecurity has an impact on their mental health status, particularly contributing to an increase in depression and anxiety.…”