Social Psychiatry and Psychiatric Epidemiology

, Volume 48, Issue 2, pp 183–193 | Cite as

Conflict and mental health: a cross-sectional epidemiological study in Nepal

  • Nagendra P. Luitel
  • Mark J. D. Jordans
  • Ram P. Sapkota
  • Wietse A. Tol
  • Brandon A. Kohrt
  • Suraj B. Thapa
  • Ivan H. Komproe
  • Bhogendra Sharma
Original Paper

Abstract

Purpose

The aim of this epidemiological study was to identify prevalence rates of mental health problems, factors associated with poor mental health and protective and risk factors in a post-conflict situation in Nepal.

Methods

This cross-sectional study was conducted among 720 adults in 2008. A three-stage sampling procedure was used following a proportionate stratified random sampling strategy. The outcome measures used in the study were locally validated with Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Post-Traumatic Stress Disorder (PTSD)—Civilian Version (PCL-C) and locally constructed function impairment scale, resources and coping.

Results

Of the sample, 27.5 % met threshold for depression, 22.9 % for anxiety, and 9.6 % for PTSD. Prevalence rates were higher among women (depression, OR 2.14 [1.52–3.47]; anxiety, OR 2.30 [1.45–3.17] and PTSD, OR 3.32 [1.87–5.89]) and older age categories (depression, OR 1.02 [1.01–1.04]; anxiety, OR 1.04 [1.03–1.05] and PTSD, OR 1.02 [1.0–1.03]). Respondents who perceived more negative impact of the conflict (e.g., hampered the business/industry; hindered in getting medical treatment, etc.) in their communities were more at risk for depression (OR 1.1 [1.06–1.14]), anxiety (OR 1.05 [1.01–1.09]) and PTSD (OR 1.09 [1.04–1.14]). Other risk factors identified in the study were ethnicity, district of residence and poverty (lack of clothing, medicine and information via radio at home).

Conclusion

Overall, the prevalence rates of depression and anxiety in the sample are comparable to, or lower than, other studies conducted with populations affected by conflict and with refugees. However, the findings underscore the need to address the current lack of mental health care resources in post-conflict rural Nepal, especially for marginalized populations.

Keywords

Political violence Mental health PTSD Risk factors Nepal 

Notes

Acknowledgments

The study was implemented through a partnership between Transcultural Psychosocial Organization (TPO) Nepal and Centre for Victim of Torture (CVICT). We thank Dr. Duncan Pederson and Dr. Laurence Kirmayer for their contributions to this study. We also thank Mr. Nawaraj Upadhaya, Santosh K. Shah and the research staff of TPO Nepal and CVICT Nepal for their support. This study has been made possible with the financial support from Douglas Mental Health University Institute Canada.

Conflict of interest

The authors declare that they have no competing interest.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Nagendra P. Luitel
    • 1
  • Mark J. D. Jordans
    • 1
    • 2
    • 3
  • Ram P. Sapkota
    • 4
  • Wietse A. Tol
    • 2
    • 5
  • Brandon A. Kohrt
    • 1
    • 6
  • Suraj B. Thapa
    • 7
  • Ivan H. Komproe
    • 2
    • 8
  • Bhogendra Sharma
    • 4
  1. 1.Transcultural Psychosocial Organization (TPO) NepalKathmanduNepal
  2. 2.Department of Research and DevelopmentHealthnet TPOAmsterdamThe Netherlands
  3. 3.Center for Global Mental HealthLondon School of Hygiene and Tropical MedicineLondonUK
  4. 4.Centre for Victims of Torture (CVICT)KathmanduNepal
  5. 5.Department of Mental Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA
  6. 6.Department of Psychiatry and Behavioral SciencesThe George Washington University School of MedicineWashingtonUSA
  7. 7.Institute of PsychiatryUniversity of OsloOsloNorway
  8. 8.Faculty of Social and Behavioural SciencesUtrecht UniversityUtrechtThe Netherlands

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