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Soc Psychiatry Psychiatr Epidemiol (2013) 48:183193 DOI 10.1007/s00127-012-0539-0
ORIGINAL PAPER
Conict and mental health: a cross-sectional epidemiological study in Nepal
Nagendra P. Luitel Mark J. D. Jordans Ram P. Sapkota Wietse A. Tol
Brandon A. Kohrt Suraj B. Thapa Ivan H. Komproe Bhogendra Sharma
Received: 1 April 2011 / Accepted: 14 June 2012 / Published online: 10 July 2012 Springer-Verlag 2012
AbstractPurpose The aim of this epidemiological study was to identify prevalence rates of mental health problems, factors associated with poor mental health and protective and risk factors in a post-conict situation in Nepal.
Methods This cross-sectional study was conducted among 720 adults in 2008. A three-stage sampling procedure was used following a proportionate stratied random sampling strategy. The outcome measures used in the study were locally validated with Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Post-Traumatic Stress Disorder (PTSD)Civilian Version (PCL-C) and locally constructed function impairment scale, resources and coping.
Results Of the sample, 27.5 % met threshold for depression, 22.9 % for anxiety, and 9.6 % for PTSD. Prevalence rates were higher among women (depression,
OR 2.14 [1.523.47]; anxiety, OR 2.30 [1.453.17] and PTSD, OR 3.32 [1.875.89]) and older age categories (depression, OR 1.02 [1.011.04]; anxiety, OR 1.04[1.031.05] and PTSD, OR 1.02 [1.01.03]). Respondents who perceived more negative impact of the conict (e.g., hampered the business/industry; hindered in getting medical treatment, etc.) in their communities were more at risk for depression (OR 1.1 [1.061.14]), anxiety (OR 1.05[1.011.09]) and PTSD (OR 1.09 [1.041.14]). Other risk factors identied in the study were ethnicity, district of residence and poverty (lack of clothing, medicine and information via radio at home).
Conclusion Overall, the prevalence rates of depression and anxiety in the sample are comparable to, or lower than, other studies conducted with populations affected by conict and with refugees. However, the ndings underscore the need to address the current lack of mental health care
N. P. Luitel (&) M. J. D. Jordans B. A. Kohrt
Transcultural Psychosocial Organization (TPO) Nepal, Baluwatar, Kathmandu, Nepale-mail: luitelnp@gmail.com
M. J. D. Jordans W. A. Tol I. H. Komproe
Department of Research and Development, Healthnet TPO, Amsterdam, The Netherlandse-mail: mark.jordans@hntpo.org
M. J. D. JordansCenter for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
R. P. Sapkota B....