Journal Article

Political violence and mental health in Nepal: prospectivestudy

Dev Sharma Vidya, Nepal, Mahendra K, Acharya, Nanda Raj, Tol, Wietse A, Kohrt, Brandon A, Thapa, Suraj B, Worthman, Carol M, Hruschka, Daniel J, Baldwin, Jennifer L, Kunz, Richard D, Koirala Suraj, Robkin Navit, Nawaraj, Upadhaya, Jordans Mark J D

2012

Overview

BackgroundPost-conflict mental health studies in low-income countries have lackedpre-conflict data to evaluate changes in psychiatric morbidity resultingfrom political violence.AimsThis prospective study compares mental health before and after exposureto direct political violence during the People's War in Nepal.MethodAn adult cohort completed the Beck Depression Inventory and Beck AnxietyInventory in 2000 prior to conflict violence in their community and in2007 after the war.ResultsOf the original 316 participants, 298 (94%) participated in thepost-conflict assessment. Depression increased from 30.9 to 40.6%.Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stressdisorder (PTSD) was 14.1%. Controlling for ageing, the depressionincrease was not significant. The anxiety increase showed a dose–responseassociation with conflict exposure when controlling for ageing and dailystressors. No demographic group displayed unique vulnerability orresilience to the effects of conflict exposure.ConclusionsConflict exposure should be considered in the context of other types ofpsychiatric risk factors. Conflict exposure predicted increases inanxiety whereas socioeconomic factors and non-conflict stressful lifeevents were the major predictors of depression. Research andinterventions in postconflict settings therefore should considerdifferential trajectories for depression v. anxiety andthe importance of addressing chronic social problems ranging from povertyto gender and ethnic/caste discrimination.

• Publisher: Cambridge University Press
• Subject: Aggression / Aging / Anxiety / Caste / Conflict / Developing countries / Displaced persons / Epidemiology / Ethnic relations / LDCs / Longitudinal studies / Low income groups / Mental depression / Mental disorders / Mental health / Morbidity / Political violence / Politics / Population aging / Post traumatic stress disorder / Psychiatric morbidity / Psychiatry / Risk factors / Sex discrimination / Social anxiety / Social problems / Socioeconomic factors / Trauma / Violence / Vulnerability / War