War and Bereavement: Consequences for Mental and Physical Distress

Nexhmedin Morina,Ulrike Von Lersner,Holly G Prigerson,Jerson Laks

doi:10.1371/journal.pone.0022140

Abstract

BackgroundLittle is known about the long-term impact of the killing of a parent in childhood or adolescence during war on distress and disability in young adulthood. This study assessed current prevalence rates of mental disorders and levels of dysfunction among young adults who had lost their father due to war-related violence in childhood or adolescence.Methods179 bereaved young adults and 175 non-bereaved young adults were interviewed a decade after experiencing the war in Kosovo. Prevalence rates of Major Depressive Episode (MDE), anxiety, and substance use disorders, and current suicide risk were assessed using the Mini–International Neuropsychiatric Interview. The syndrome of Prolonged Grief Disorder (PGD) was assessed with the Prolonged Grief Disorder Interview (PG-13). Somatic symptoms were measured with the Patient Health Questionnaire. General health distress was assessed with the General Health Questionnaire.FindingsBereaved participants were significantly more likely to suffer from either MDE or any anxiety disorder than non-bereaved participants (58.7% vs. 40%). Among bereaved participants, 39.7% met criteria for Post-Traumatic Stress Disorder, 34.6% for PGD, and 22.3% for MDE. Bereaved participants with PGD were more likely to suffer from MDE, any anxiety disorder, or current suicide risk than bereaved participants without PGD. Furthermore, these participants reported significantly greater physical distress than bereaved participants without PGD.ConclusionWar-related loss during middle childhood and adolescence presents significant risk for adverse mental health and dysfunction in young adulthood in addition to exposure to other war-related traumatic events. Furthermore, the syndrome of PGD can help to identify those with the greatest degree of distress and dysfunction.

Highlights

Recent and ongoing wars and open conflicts have affected millions of civilians around the globe and about half of the survivors have been estimated to be under the age of 18 years [1,2]
The syndrome of Prolonged Grief Disorder (PGD) can help to identify those with the greatest degree of distress and dysfunction
Compared to non-bereaved participants, bereaved participants were significantly more likely to suffer from Major Depressive Episode (MDE), post-traumatic stress disorder (PTSD), and Panic Disorder

Summary

Introduction

Recent and ongoing wars and open conflicts have affected millions of civilians around the globe and about half of the survivors have been estimated to be under the age of 18 years [1,2]. Research indicates enduring psychiatric sequelae in young and adult civilians of war and political violence even many years following war-related traumatic experiences [3,4,5,6]. There is evidence that unnatural death of a parent during childhood and adolescence, such as parental suicide, possesses a stronger association with psychiatric sequelae than sudden natural parental death [10,11]. These findings are consistent with research among adults indicating that bereaved individuals are more likely to suffer from physical and mental symptoms and to use health services more often than non-bereaved individuals [12]. This study assessed current prevalence rates of mental disorders and levels of dysfunction among young adults who had lost their father due to war-related violence in childhood or adolescence

Methods

Results

Conclusion