Association of exposure to violence and potential traumatic events with self-reported physical and mental health status in the Central African Republic

TitleAssociation of exposure to violence and potential traumatic events with self-reported physical and mental health status in the Central African Republic
Publication TypeJournal Article
AuthorsVinck, P., and P. N. Pham
CONTEXT: For decades, the Central African Republic (CAR) has experienced violence, economic stagnation, and institutional failure. The latest wave of violence erupted in 2001 and continues to this day in some areas. Yet there has been little attention to the conflict and even less research to document and quantify the conflict's human cost. OBJECTIVE: To study levels of violence in CAR, including mortality levels, and the association between exposure to violence and traumatic events with self-reported physical and mental health status. DESIGN, SETTING, AND PARTICIPANTS: Multistage stratified cluster random survey of 1879 adults 18 years or older in selected households conducted in 5 administrative units of CAR (3 in the south, which has been free from recent violence, and 2 in the north, in which violence continues) between October and December 2009. MAIN OUTCOME MEASURES: Mortality, morbidity, exposure to potential traumatic events, sense of insecurity, and meeting of symptom criteria for depression and anxiety using the Hopkins Symptom Checklist-25 with a cut-off score of 1.75. RESULTS: The crude mortality rate (CMR) was 4.9 deaths (95% confidence interval [CI], 4.6-5.1) per 1000 population per month and self-reported CMR due to violence was 0.8 deaths (95% CI, 0.6-1.0) per 1000 population per month. Thirty-five percent reported their physical health status as being good or very good while 29% described it as bad or very bad. Respondents in northern prefectures reported higher rates of mortality, exposure to trauma, and insecurity and lower levels of physical health and access to health services compared with those in the south. The estimated prevalences of symptoms of depression and anxiety were 55.3% (95% CI, 51.6%-59.0%) and 52.5% (95% CI, 48.1%-56.8%), respectively. Exposure to violence and self-reported physical health were statistically associated with mental health outcomes (P < .001). Anxiety symptom scores were higher for respondents in the northern prefectures than those in the south (t = 2.54, P = .01). CONCLUSION: A high proportion of adult respondents in CAR reported witnessing or having personally experienced traumatic events over the course of the conflicts, and more than half met symptom criteria for depression and anxiety.
Title Association of exposure to violence and potential traumatic events with self-reported physical and mental health status in the Central African Republic
Publication Title JAMA
Publication Type Journal Article
Published Year 2010
Authors P. Vinck; P.N. Pham
Accession Number 20682934
Number 5
ISBN Number 1538-3598 (Electronic)<br/>0098-7484 (Linking)
Grant List
-

JOIN THE CONVERSATION

For breaking news and to stay connected, follow us on social media. Sign up to get our E-News delivered straight to your inbox.