Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Research article

Prevalence and factors associated with Posttraumatic Stress Disorder seven years after the conflict in three districts in northern Uganda (The Wayo-Nero Study)

Authors: James Mugisha, Herbert Muyinda, Peter Wandiembe, Eugene Kinyanda

Published in: BMC Psychiatry | Issue 1/2015

Login to get access

Abstract

Background

Research on the prevalence of Posttraumatic Stress Disorder (PTSD) is still limited in low income countries yet PTSD can be a public health problem in post conflict areas. In order to respond to the burden of PSTD in northern Uganda, an area that experienced civil strife for over two decades, we need accurate data on its (PTSD) prevalence and the associated risk factors to facilitate public mental health planning.

Methods

This study employed a cross-sectional study design and data collection was undertaken in three districts in northern Uganda: Gulu, Amuru and Nwoya. Respondents were aged 18 years and above and were randomly selected at community level. A total of 2400 respondents were interviewed using a structured questionnaire in the three study districts. In this study, multivariate logistic regression was employed to analyze the associations of socio-demographic factors, trauma related variables and the outcome of PTSD.

Results

The prevalence of Posttraumatic Stress Disorder (PTSD) in the study population was 11.8 % (95 % CI: 10.5 %, 13.1 %) with a prevalence of 10.9 % (95 % CI: 9.3 %, 12.5 %) among female respondents and 13.4 % (95 % CI: 11.2 %, 15.7 %) among male respondents. Quite a number of factors were strongly associated with PTSD. Overall, a respondent had experienced 9 negative life events. In a multivariate logistic regression, the factors that were strongly associated with PTSD were: exposure to war trauma events, childhood trauma, negative life events, negative copying style and food insecurity. The findings also indicate no association between sex, age and PTSD.

Conclusion

The prevalence rate of PTSD in the study communities is unacceptably high. Quite a number of factors were associated with PTSD. Effective public mental health services are needed that combine treatment (medical) psychological and social welfare programs especially at community level to address the high burden of PTSD. Longitudinal studies are also recommended to continuously assess the trends in PTSD in the study communities and remedial action taken.
Literature
1.
Amone-P’Olak K, Nyeko OB, Opio G, Ovuga E, Meiser-Sterdman. War experiences and psychiatric symptoms among former child soldiers in northern Uganda: the mediating role of post-war hardships-the WAYS study. Soc Pyschairty Epideiol. 2014;49(11):1783–92. doi:10.​1007/​s00127-014-0873-5.CrossRef
2.
Annan J, Blattman C. Survey of war affected youth. United Nations Children Fund (UNICEF): Kampala; 2006.
3.
4.
5.
Bernstein DP, Fink L. Childhood trauma questionnaire: a retrospective self-report: manual. Harcourt Brace & Company: San Antonia, TX; 1998.
6.
Bolton P, Bass J, Betancourt T, Speelman L, Onyango G, Clougherty KF, et al. Interventions for depression symptoms among adolescent survivors of war and displacement in Northern Uganda: a randomized controlled trial. J Am Med Assoc. 2007;298(5):519–27.CrossRef
7.
Canetti D, Galea S, Hall BJ, Johnson RJ, Palmieri PA, Hobfoll SE. Exposure to prolonged socio-political conflict and the risk of PTSD and depression among Palestinians. Transcult Psychiatry. 2010;73(3):219–31.
8.
Dahlem NW, Zimet GD, Walker RR. The multidimensional scale of perceived social support: a confirmation study. J Clin Psychol. 1991;47(6):756–61.CrossRefPubMed
9.
ElSarraj E, Punamaki RL, Salmi S, Summerfield D. Experiences of torture and ill treatment and posttraumatic stress disorder symptoms among Palestinian political prisoners. Journal of Truama Stress. 1996;9:595–606.CrossRef
10.
Greening L, Stoppelbein L. Brief report: pediatric cancer, parental coping style, and risk to depression, posttraumatic stress and anxiety symptoms. J Pediatr Psychol. 2007;32(10):1272–7.CrossRefPubMed
11.
Hadley C, Tegegn A, Tessema F, Cowan JA, Asefa M, Galea S. Food insecurity, stressful life events and symptoms of anxiety and depression in east Africa: evidence from the Gilgel Gibe growth and development study. J Epidemiol Community Health. 2008;62(11):980–6. doi:10.​1136/​jech.​2007.​068460.CrossRefPubMed
12.
Joop TV, De Jong JTVM, Komproe IH, Ommeren MV, ElMasri M, Araya M, et al. Lifetime events and Posttraumatic Stress Disorder in 4 post-conflict settings. JAMA. 2001;286:555–62.CrossRef
13.
Karunakara UK, Neuner F, Schauer M, Singh K, Hill K, Elbert T, et al. Traumatic events and symptoms of post-traumatic stress disorder amongst Sudanese nationals, refugees and Ugandans in the West Nile. Afr Health Sci. 2004;4(2):83–93.PubMedPubMedCentral
14.
Kerkhof A, Bernasco W, Bille-Brahe U, Platt S, Schmidtke A. WHO/EURO multicentrestudy on parasuicide: European parasuicide study interview schedule (EPSIS). Leiden: Department of Clinical Health and Personality Psychology, Leiden University; 1989.
15.
Kinyanda E, Waswa L, Baisley K, Maher D. Prevalence of severe mental distress and its correlates in a population-based study in rural south-west Uganda. BMC Psychiatry. 2011;11:97.CrossRefPubMedPubMedCentral
16.
Kirkwood B, Sterne J. Medical Statistics. 2 Oxfordth ed. Blackweel Science: Hoboken, NJ, USA; 2003.
17.
Kizza D, Knizek BL, Kinyanda E, Hjelmeland H. An escape from agony: a qualitativepsychological autopsy study of women's suicide in a post-conflict northern Uganda. Int JQual Stud Health Well-being. 2012;7:1–13.
18.
Kolassa I, Ertl V, Eckart C, Kolassa S, Onyut LP, Elbert T. Spontaneous remission from PTSD depends on the number of traumatic event types experienced. Psychol Trauma. 2010;2(3):169–74.CrossRef
19.
Kuwert P, Spitzer C, Träder A, Freyberger, HJ, Ermann M. Sixty years later: post-traumatic stress symptoms and current psychopathology in former German children of World War II. Int Psychogeriatr Assoc. 2006; 1–7. doi:10.​1017/​S104161020600442​X.
20.
McFarlane AC. Posttraumatic stress disorder: a model of the longitudinal course and the role of the risk factors. J Clin Psychiatry. 2000;6:15–23.
21.
Mollica RF, Donelan K, Tor S, Lavelle J, Elias C, Frankel M et al. The effect of trauma and confinement on functional health and mental health status of Cambodians living in Thailand-Cambodia boarder camps. JAMA. 1993;270:581–6.
22.
23.
24.
25.
Muyinda H. Limbs and Lives: Disability, Violent Conflict, and Embodied Sociality in Northern Uganda. PhD dissertation: University of Copenhagen; 2008.
26.
Okello ES. Cultural explanatory models of depression in Uganda. Doctoral Thesis. Stockholm, Sweden: Kalolinska University; 2006. Makerere University, Kampala, Uganda.
27.
Onyut LP, Neuner F, Ertl V, Schauer E, Odenwald M, Elbert T. Trauma, poverty and mental health among Somali and Rwandese refugees living in an African refugee settlement – an epidemiological study. Confl Heal. 2009;3:6. doi:10.​1186/​1752-1505-3-6.CrossRef
28.
Ovuga E, Boardman J, Wasserman D. The prevalence of depression in two districts of Uganda. Soc Psychiatry Psychiatr Epidemiol. 2005;40(6):439–45.CrossRefPubMed
29.
Pfeiffer A, Elbert T. PTSD, depression and anxiety among former abductees in Northern Uganda. Confl Heal. 2011;5(1):14.CrossRef
30.
Pharm PN, Weinstein HM, Longman T. Trauma & PTSD symptoms in Rwanda. Implications for attitudes toward justice and reconciliation. JAMA. 2004;292:602–12.CrossRef
31.
32.
Rieder H, Elbert T. Rwanda-Lasting imprints of genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners and their children. Confl Heal. 2013;7:6.CrossRef
33.
Roberts B, Ocaka KF, Browne J, Oyok T, Sondorp E. Factors associated with posttraumatic stress disorder and depression amongst internally displaced persons in northern Uganda. BMC Psychiatry. 2008;8:38.CrossRefPubMedPubMedCentral
34.
Schaal S, Dusingizemungu JP, Jacob N, Elbert T. Rates of trauma spectrum disorders and risks of posttraumatic stress disorder in a sample of orphaned and widowed genocide survivors. Eur J Psychotraumatol. 2011;2:6343. doi:10.​3402/​ejpt.​v210.​6343.CrossRef
35.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–33.PubMed
36.
Shresta NM, Sharma B, Van Ommeren M, Regmis S, Regmi S, Makaju R, et al. The impact of torture on refuges displaced within the developing world. Symptomatology among the Bhutanese refuges in Nepal. JAMA. 1998;280:443–8.CrossRef
37.
Steel Z, Chey T, Silove D, Marnane C, Bryant RA, Ommeren VM. Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA. 2009;302(5):537–49.CrossRefPubMed
38.
Thabet AAM, Abed Y, Vostanis P. Co-morbidity of PTSD and depression among refugee children during war conflict. J Child Psychol Psychiatry. 2004;45(3):533–54.CrossRefPubMed
39.
40.
Williams CL, Berry JW. Primary prevention of acculturative stress among refugees: application of psychological theory and practice. Am psycho. 1991;46:632–41.CrossRef
41.
Winkler N, Ruf-Leuschner M, Ertl V, Pfeiffer A, Schalinski I, Ovuga E, et al. From war to classroom: PTSD and depression in formely abducted youth in Uganda. Front Psychaitry. 2015. doi:10.​3389/​fpsy.​2015.​00002.
Metadata
Title
Prevalence and factors associated with Posttraumatic Stress Disorder seven years after the conflict in three districts in northern Uganda (The Wayo-Nero Study)
Authors
James Mugisha
Herbert Muyinda
Peter Wandiembe
Eugene Kinyanda
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0551-5

Other articles of this Issue 1/2015

BMC Psychiatry 1/2015 Go to the issue

Research article

Parental care protects traumatized Sri Lankan children from internalizing behavior problems

Research article

The development and psychometric properties of a measure of clinicians’ attitudes to depression: the revised Depression Attitude Questionnaire (R-DAQ)

Research article

The pain of a heart being broken: pain experience and use of analgesics by caregivers of patients with Alzheimer’s disease

Study protocol

A randomized controlled trial of Mindfulness-Based Cognitive Therapy (MBCT) versus treatment-as-usual (TAU) for chronic, treatment-resistant depression: study protocol

Research article

Season of birth is different in Inuit suicide victims born into Traditional than into Modern Lifestyle: a register study from Greenland

Research article

Caregivers consequences of care among patients with eating disorders, depression or schizophrenia