Post-traumatic stress disorder, psychiatric comorbidities and associated factors among refugees in Nakivale camp in southwestern Uganda
Post-traumatic stress disorder, psychiatric comorbidities and associated factors among refugees in Nakivale camp in southwestern Uganda
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DOI：
10.1186/s12888-020-2480-1
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发表时间：
2020-02-07
期刊：
影响因子：
4.4
通讯作者：
Ashaba, Scholastic
中科院分区：
文献类型：
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作者：
Bapolisi, Achille Mwira;Song, Suzan J.;Ashaba, Scholastic
背景非洲的武装冲突已导致2420多万人流离失所，其中140多万人生活在乌干达。研究表明，生活在乌干达难民安置点的难民患创伤后应激障碍的风险增加。然而，缺乏关于乌干达难民中抑郁、焦虑和物质使用障碍等其他精神健康问题流行率的数据。我们的目的是确定纳基瓦莱难民营难民中创伤后应激障碍的流行率、其主要的精神共病和可感知的心理社会需求。方法对来自9个不同来源国的387名难民营居民进行横断面调查。使用迷你国际神经精神病学访谈(MINI)和人道主义新兴环境感知需求量表(Hesper)评估精神障碍。结果难民精神障碍患病率较高，需求感知水平较高。最常见的精神障碍是广泛性焦虑症(73%)、创伤后应激障碍(PTSD)(67%)、严重抑郁障碍(58%)和物质使用障碍(30%)。创伤后应激障碍与物质使用障碍(OR=5.13)、重度抑郁障碍(OR=4.04)、广泛性焦虑障碍(OR=3.27)的共病水平较高。在多因素分析中，创伤后应激障碍与认为压力是一个严重问题(OR=6.52；P值=0.003)、对社区妇女的安全和保护(OR=2.35；P值=0.011)、对家庭的关心(OR=2.00；P值=0.035)和居住地(OR=1.83；P值=0.04)呈正相关。在应用Bonferroni校正后，应激感觉仍然与创伤后应激障碍显著相关。结论我们的研究结果表明，创伤后应激障碍及其主要合并症与纳基瓦莱难民营的基本需求之间存在很强的相关性。心理健康支助应包括心理干预和社会援助，以改善难民的健康。
Background Armed conflict in Africa has led to displacement of over 24.2 million people, more than 1.4 million of whom are living in Uganda. Studies show that refugees living in Ugandan refugee settlements are at increased risk for post-traumatic stress disorder. However data on the prevalence of other mental health problems among refugees including depression, anxiety and substance use disorder among refugees in Uganda is lacking. Our aim was to determine the prevalence of post-traumatic stress disorder, its main psychiatric comorbidities and perceived psychosocial needs among refugees in Nakivale refugee camp. Methods We conducted a cross-sectional survey of refugee camp residents (n = 387) from nine different countries of origin. Psychiatric disorders were assessed using the MINI International Neuropsychiatric Interview (MINI) and perceived needs by the Humanitarian Emerging Settings Perceived Needs Scale (HESPER). Results The prevalence of psychiatric disorders was high among refugees as was the level of perceived needs. The most prevalent psychiatric disorders were generalized anxiety disorders (73%), post-traumatic stress disorder (PTSD) (67%), major depressive disorder (58%) and substance use disorders (30%). There was a higher level of comorbidity between PTSD and substance use disorder (OR = 5.13), major depressive disorder (OR = 4.04) and generalized anxiety disorder (OR = 3.27). In multivariate analysis, PTSD was positively associated with the perception of stress as a serious problem (OR = 6.52; P-value = 0.003), safety and protection for women in the community (OR = 2.35; P-value = 0.011), care for family (OR = 2.00; P-value = 0.035) and Place to live in (OR = 1.83; P-value = 0.04). After applying the Bonferroni correction, the perception of stress remained significantly associated with PTSD. Conclusion Our findings suggest a strong association between PTSD, its main comorbidities and basic needs in Nakivale refugee camps. Mental health support should include psychological interventions as well as social assistance to improve the health of refugees.