Common mental disorders in postconflict settings

• Published in: The Lancet (British edition) Vol. 361; no. 9375; pp. 2128 - 2130
• Main Authors: de Jong, Joop TVM, Komproe, Ivan H, Van Ommeren, Mark
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 21-06-2003; Lancet; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Aggression; Algeria - epidemiology; Anxiety; Anxiety Disorders - epidemiology; Biological and medical sciences; Cambodia - epidemiology; Comorbidity; Complications; Conflicts; Diagnostic systems; Ethiopia - epidemiology; Female; General populations; Humans; Low income areas; Male; Medical sciences; Mental disorders; Mental health; Middle Aged; Middle East - epidemiology; Mood; Mood Disorders - epidemiology; Post traumatic stress disorder; Prevalence; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk factors; Somatoform Disorders - epidemiology; Stress Disorders, Post-Traumatic - epidemiology; Tropical medicine; Violence; Algeria; Cambodia; Asia; Ethiopia; Africa; Middle East; Gaza Strip; Human; Mood disorder; Political conflict; Posttraumatic syndrome; Prevalence; Mental disorder; Sequela; Anxiety; Epidemiology; Public health
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(03)13692-6

Research into postconflict psychiatric sequelae in low-income countries has been focused largely on symptoms rather than on full psychiatric diagnostic assessment. We assessed 3048 respondents from postconflict communities in Algeria, Cambodia, Ethiopia, and Palestine with the aim of establishing the prevalence of mood disorder, somatoform disorder, post-traumatic stress disorder (PTSD), and other anxiety disorders. PTSD and other anxiety disorders were the most frequent problems. In three countries, PTSD was the most likely disorder in individuals exposed to violence associated with armed conflict, but such violence was a common risk factor for various disorders and comorbidity combinations in different settings. In three countries, anxiety disorder was reported most in people who had not been exposed to such violence. Experience of violence associated with armed conflict was associated with higher rates of disorder that ranged from a risk ratio of 2·10 (95% CI 1·38–2·85) for anxiety in Algeria to 10·03 (5·26–16·65) for PTSD in Palestine. Postconflict mental health programmes should address a range of common disorders beyond PTSD.