Abstract
BackgroundThis survey attempts to measure at a national level, exposures to major traumas and the prevalence of common mental health disorders in a low-income dangerous country, highly affected by conflicts: Afghanistan.MethodsTrans-sectional probability survey in general population by multistage sampling in 8 provinces, represented nationwide: 4445 adults (4433 weighted),15 years or older, 81% participation rate. Face to face interviews used specific scales for measuring lifetime exposure (LEC 5 Life Events Checklist) and Post Traumatic Stress Disorder (PTSD Check List), a diagnostic standardized interview: Composite International Diagnostic Interview (Short Form) for.Major Depressive Episode and Generalized Anxiety Disorder, plus scales for suicidal thoughts and attempts and psychological distress (MH5 and RE from SF36).Results52.62% of the population is illiterate, 84,61% of the women do not have any source of income; 70.92% of the population lives in rural areas, 60.62% are below 35 years, 80% lives in very dangerous areas. 64.67% of the Afghan population had personally experienced at least one traumatic event; 78.48% had witnessed one such event. 60.77% of the sample experienced collective violence in relation to war and 48.76% reported four or more events; this very much differs across regions and levels of danger; women are less at risk for trauma except sexual violence, 35 years and above are more at risk than younger. 12-month PTSD prevalence reaches a high rate: 5.34% as MDE 11,71%, whereas GAD 2.78%; suicidal thoughts 2.26%, lifetime suicidal attempts 3.50% are close to reported in other countries. Women have more risk for PTSD (0R = 1.93) and suicidal behaviours (attempts OR = 1.92) than men; the number of events increases risk for MDE, PTSD and suicidal attempts, whereas education is protective. Exposure to different war events produced different mental health effects. People suffering from PTSD have higher risk to report 12-months suicidal ideations and lifetime suicidal attempts.ConclusionOur findings highlight the need to map the extent and the types of mental disorders post conflict; this would help maximise the help to be offered in guiding proper choice of interventions, including education.
Highlights
This survey attempts to measure at a national level, exposures to major traumas and the prevalence of common mental health disorders in a low-income dangerous country, highly affected by conflicts: Afghanistan
A wealth of evidence from both high income and low income countries indicates that war and political violence are associated with high rates of mental health disorders and are associated with the risk of long-term mental health problems [4], yet the impact of war and disaster on mental health in Afghanistan is insufficiently researched
The screening tools used by both studies—the Hopkins Symptom Check List and Hopkins Trauma Questionnaire— well-known and largely used, were not designed to distinguish between mental disorders and reactions to severe environmental stress
Summary
This survey attempts to measure at a national level, exposures to major traumas and the prevalence of common mental health disorders in a low-income dangerous country, highly affected by conflicts: Afghanistan. It has forced Afghans to live through challenging conditions, such as frequently being bereaved, having their land and properties damaged, being forcefully obliged to move internally or externally, and being imprisoned and tortured in neighboring countries as well [2] Recurring natural disasters, such as drought and earthquakes, had an impact on the mental health and well-being of the Afghan population [3]. The rates of measured disorders do not reflect the experience of clinicians, especially a high rate of reported PTSD, which may be indicative of nonrepresentative sampling or other methodological problems [9] None of these studies, with the exception of the last cited, were recent and none extensively measured the diverse mental health disorders following DSM classifications criteria and risk associate factors
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