Abstract
BackgroundViolence and traumatic events are highly prevalent among refugees, but less is known about the impact of these experiences among self-settled refugees in the country of asylum. We evaluated the association between traumatic experiences and PTSD and depression symptoms among female Democratic Republic of Congo (DRC) refugees living in Kampala, Uganda.MethodsParticipants were recruited using respondent driven sampling in one refugee service center in Kampala, Uganda. Eligibility criteria included: Congolese nationality, age 18+ years, self-settled in Kampala for at least 6 months, refugee status or documentation of application for refugee status. Only data from female participants were included in this analysis. Depression symptoms were screened with the Patient Health Questionnaire-2, and symptom criteria for PTSD and traumatic experiences were evaluated with the Harvard Trauma Questionnaire. Logistic regression models were performed to separately assess associations between mental health outcomes (PTSD and depression), rape and non-sexual violence.ResultsFive hundred eighty women with a mean age of 33 years were interviewed. Among participants, 73% (95% CI:67–78%) met symptom criteria for PTSD, 57% (95% CI: 51–63%) for depression, and 65% reported thoughts of ending one’s life. 79% of women reported experience of rape, for over half (54%) it occurred more than once, and 82% were gang raped. Crude and adjusted odds ratios (ORs) show that PTSD was most strongly associated with being raped (OR = 2.43, p < 0.01), lacking shelter (OR = 2.86, p < 0.01), lacking food or water (OR = 2.53, p = 0.02), lacking access to health care (OR = 2.84, p < 0.01), forced labor (OR = 2.6, p < 0.01), extortion and/or robbery (OR = 3.08, p < 0.01), experiencing the disappearance/kidnapping of a family member or friend (OR = 2.72, p < 0.01), and witnessing the killing or murder of other people (OR = 3.28, p < 0.01). Depression was significantly associated with several traumatic experiences including rape (OR = 2.3, p = 0.01), and experiencing the disappearance/kidnapping of a child or spouse (OR = 1.99, p = 0.01).ConclusionsRefugee women self-settled in Kampala reported high lifetime experiences of violence and traumatic events including rape, as well as high rates of PTSD and depression. Future programming addressing self-settled refugees and their settlement in host countries may benefit from including local and national integration strategies.
Highlights
Violence and traumatic events are highly prevalent among refugees, but less is known about the impact of these experiences among self-settled refugees in the country of asylum
Refugee women self-settled in Kampala reported high lifetime experiences of violence and traumatic events including rape, as well as high rates of post-traumatic stress disorder (PTSD) and depression
The purpose of this study was to investigate rates of PTSD and depression symptoms in a population of female DR Congolese refugees living in Kampala, Uganda and their association with traumatic experiences including rape, to inform policy and service provision in host countries
Summary
Violence and traumatic events are highly prevalent among refugees, but less is known about the impact of these experiences among self-settled refugees in the country of asylum. The events leading to forced migration, as well as flight itself and life in the country of asylum, are frequently accompanied by exposure to an array of traumatic events such as severe physical and sexual violence, death threats, witnessing family and others being killed, kidnapped, or abused [4]. These events can be emotionally shocking, and rates of stress and mental health disorders, such as anxiety disorders, post-traumatic stress disorder (PTSD), and depression are higher among refugees than in the general population [5]
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