Abstract
BackgroundResearch on the long-term mental health consequences of war and displacement among civilians who live in post-conflict countries is rare. The aim of this study was to examine the developmental trajectories and predictors of general psychological distress in three samples of Bosnian war survivors over an 11-year period.MethodsIn 1998/99, about three years after the war in Bosnia and Herzegovina, a representative sample of 299 adult Sarajevo citizens was examined in three subsamples: individuals who had stayed in Sarajevo throughout the siege, individuals who had been internally displaced, and refugees who had returned. Of the 138 study participants who could be located 11 years later, 100 were re-assessed (71%) using the Brief Symptom Inventory.ResultsOver time, psychological symptoms and general psychological distress decreased in those survivors who had stayed and increased in returnees. Former displaced persons did not show any significant changes. After controlling for other factors, cumulative trauma exposure before and during the war predicted general psychological distress at baseline. Eleven years later, higher trauma exposure during and after the war, returnee status, and more current stressors were all associated with higher levels of general psychological distress.ConclusionsLevels of psychological symptoms remained high in three subsamples of Bosnian war survivors. The differential symptom trajectories may correspond to distinct war experiences and contemporary stressors. Still, the cumulative effect of war traumata on mental distress persisted more than a decade after war and displacement, although the influence of current stressors seemed to increase over time.
Highlights
Research on the long-term mental health consequences of war and displacement among civilians who live in post-conflict countries is rare
(2019) 19:1 course and predictors of general mental health of people affected by the war in Bosnia and Herzegovina (BiH) from 1992 to 1995 who live in the post-conflict region
In a 3-year follow-up on Bosnian refugees in Croatia, about four years after the war, Mollica et al [11] found that 43% of those who met the criteria for depression at baseline continued to do so, and that an additional 16% had become symptomatic
Summary
Research on the long-term mental health consequences of war and displacement among civilians who live in post-conflict countries is rare. It is important to evaluate the long-term impact of war traumatization on the mental (2019) 19:1 course and predictors of general mental health of people affected by the war in Bosnia and Herzegovina (BiH) from 1992 to 1995 who live in the post-conflict region. In a 1.5-year follow-up on a sample of Kosovar Albanian refugees in Sweden, PTSD rates and depression symptoms increased, and even more so in asylum seekers than in those who had returned to Kosovo at follow-up [12, 13]. PTSD rates and self-reported mental health improved over a 6-year follow-up period in another sample of war-affected Kosovar Albanians [14]. Psychological symptom levels seem to increase in the early post-conflict period and decline over the ensuing years
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