Psychiatric disorders among war-abducted and non-abducted adolescents in Gulu district, Uganda: a comparative study

Gulu University, Uganda.
African Journal of Psychiatry (Impact Factor: 0.73). 12/2007; 10(4):225-31. DOI: 10.4314/ajpsy.v10i4.30260
Source: PubMed

ABSTRACT Objective:We aimed to assess the nature and patterns of psychiatric disorders among adolescents who had been war-abducted in the war in northern Uganda, compared to non-abducted adolescents living in Gulu district, Uganda.Method: A cros sectional study that used an unmatched case-control design compared 82 abducted and 71 non-abducted adolescents for scores on measures of psychological distress and for selected psychiatric diagnoses using the Strength and Difficulties Questionnaire (SDQ) and the Mini International Neural-Psychiatric Interview for Children and Adolescents English version 2.0 (M.I.N.I-KID). Results: More than 90% of adolescents reported exposure to severe trauma, either through direct or indirect experiences. Significantly more war abducted adolescents reported PTSD (26.8%v.12.7%) (p=0.03) major depression (19.5%v.4.2%) (p=0.004), and generalised anxiety disorder (13.4v.4.2%) (p=0.049) than non abducted adolescents. By contrast, non-abducted adolescents reported more past suicidality (p=0.004, chi(2)=8.2) than adolescents who were abducted. However, despite high rates of psychiatric disorder, these adolescents had good psychosocial adjustment. Conclusion: Adolescents in war affected areas whether warabducted or not have varied and clinically significant emotional responses to different kinds of traumatic exposure. In a war-affected area, the development of a sustainable service for adolescents that tries to address the full range of mental health problems may be more appropriate than a psychological trauma service that focuses on one diagnosis.

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Available from: Seggane Musisi, Aug 03, 2015
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    • "IDPs were indicated to have a prevalence of PTSD of 74% in 2005 (Vink et al., 2007), 54% in 2006 (Roberts et al., 2008), and former abductees had a prevalence of 49% in 2005 (Pfeiffer & Elbert, 2011). The lower levels of symptom reportage in our sample of humanitarian workers may variously be accounted for by differential exposure, the relative peace that has held in northern Uganda since 2007 (with lower incidence of trauma and violence), and the diminution of symptoms over time (Green et al., 1990; Okello, Onen, & Muisus, 2007). "
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    ABSTRACT: This study examined the mental health of national humanitarian aid workers in northern Uganda and contextual and organizational factors predicting well-being. A cross-sectional survey was conducted among 376 national staff working for 21 humanitarian aid agencies. Over 50% of workers experienced 5 or more categories of traumatic events. Although, in the absence of clinical interviews, no clinical diagnoses were able to be confirmed, 68%, 53%, and 26% of respondents reported symptom levels associated with high risk for depression, anxiety disorders, and posttraumatic stress disorder (PTSD), respectively. Between one quarter and one half of respondents reported symptom levels associated with high risk regarding measured dimensions of burnout. Female workers reported significantly more symptoms of anxiety, depression, PTSD, and emotional exhaustion than males. Workers with the United Nations and related agencies reported fewest symptoms. Higher levels of social support, stronger team cohesion, and reduced exposure to chronic stressors were associated with improved mental health. National humanitarian staff members in Gulu have high exposure to chronic and traumatic stress and high risk of a range of poor mental health outcomes. Given that work-related factors appear to influence the relationship between the two strategies are suggested to support the well-being of national staff working in such contexts.
    Journal of Traumatic Stress 12/2012; 25(6):713-20. DOI:10.1002/jts.21764 · 2.72 Impact Factor
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    • "Five of the studies incorporated a comparison group of children not associated with an armed group (Betancourt, Borisova, de la Soudière, & Williamson, 2011; Blattman & Annan, 2010; Kohrt et al., 2008; MacMullin & Loughry, 2004; Okello, Onen, & Musisi , 2007). Okello et al. (2007) identified a comparison group from a local mixed boarding and day college, whereas Betancourt and colleagues (2010) included a random door-to-door sample of war-affected youth from the same villages of resettlement as a cohort of former child soldiers. Only two studies used a matching procedure for establishing a comparison group (Blattman & Annan, 2010; Kohrt et al., 2008). "
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    ABSTRACT: Aims and scope:  This article reviews the available quantitative research on psychosocial adjustment and mental health among children (age <18 years) associated with armed forces and armed groups (CAAFAG) - commonly referred to as child soldiers. Methods:  PRISMA standards for systematic reviews were used to search PubMed, PsycInfo, JSTOR, and Sociological Abstracts in February 2012 for all articles on former child soldiers and CAAFAG. Twenty-one quantitative studies from 10 countries were analyzed for author, year of publication, journal, objectives, design, selection population, setting, instruments, prevalence estimates, and associations with war experiences. Opinion pieces, editorials, and qualitative studies were deemed beyond the scope of this study. Quality of evidence was rated according to the Systematic Assessment of Quality in Observational Research (SAQOR). Findings:  According to SAQOR criteria, among the available published studies, eight studies were of high quality, four were of moderate quality, and the remaining nine were of low quality. Common limitations were lack of validated mental health measures, unclear methodology including undefined sampling approaches, and failure to report missing data. Only five studies included a comparison group of youth not involved with armed forces/armed groups, and only five studies assessed mental health at more than one point in time. Across studies, a number of risk and protective factors were associated with postconflict psychosocial adjustment and social reintegration in CAAFAG. Abduction, age of conscription, exposure to violence, gender, and community stigma were associated with increased internalizing and externalizing mental health problems. Family acceptance, social support, and educational/economic opportunities were associated with improved psychosocial adjustment. Conclusions:  Research on the social reintegration and psychosocial adjustment of former child soldiers is nascent. A number of gaps in the available literature warrant future study. Recommendations to bolster the evidence base on psychosocial adjustment in former child soldiers and other war-affected youth include more studies comprising longitudinal study designs, and validated cross-cultural instruments for assessing mental health, as well as more integrated community-based approaches to study design and research monitoring.
    Journal of Child Psychology and Psychiatry 10/2012; 54(1). DOI:10.1111/j.1469-7610.2012.02620.x · 5.67 Impact Factor
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    • "Symptoms endorsed during the assessment suggested scores in the diagnostic range for PTSD in one third of the children. This finding is in line with the rate reported by Okello et al.(2007) "
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    ABSTRACT: The present study examines the effect of war and domestic violence on the mental health of child soldiers in a sample consisting of 330 former Ugandan child soldiers (age: 11-17 years, female: 49%). All children had experienced at least 1 war-related event and 78% were additionally exposed to at least 1 incident of domestic violence. Prevalences of posttraumatic stress disorder and major depressive disorder were 33%, and 36%, respectively. Behavioral and emotional problems above clinical cutoff were measured in 61%. No gender differences were found regarding mental health outcomes. War experience and domestic violence were significantly associated with all mental health outcomes. The authors' findings point to the detrimental effects of domestic violence in addition to traumatizing war experiences in child soldiers.
    Journal of Traumatic Stress 10/2010; 23(5):573-81. DOI:10.1002/jts.20557 · 2.72 Impact Factor
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