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Major depressive disorder seven years after the conflict in northern Uganda: burden, risk factors and impact on outcomes (The Wayo-Nero Study)

BACKGROUND: Major depressive disorder (MDD) is a major public health burden in conflict areas. However, it is not known for how long and by how much the observed high rates of MDD seen in conflict settings persist into the post-conflict period. METHODS: A cross sectional survey was employed seven ye...

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Autores principales: Mugisha, James, Muyinda, Herbert, Malamba, Samuel, Kinyanda, Eugene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376071/
https://www.ncbi.nlm.nih.gov/pubmed/25881310
http://dx.doi.org/10.1186/s12888-015-0423-z
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author Mugisha, James
Muyinda, Herbert
Malamba, Samuel
Kinyanda, Eugene
author_facet Mugisha, James
Muyinda, Herbert
Malamba, Samuel
Kinyanda, Eugene
author_sort Mugisha, James
collection PubMed
description BACKGROUND: Major depressive disorder (MDD) is a major public health burden in conflict areas. However, it is not known for how long and by how much the observed high rates of MDD seen in conflict settings persist into the post-conflict period. METHODS: A cross sectional survey was employed seven years after the conflict in northern Uganda had ended in the three districts of Amuru, Gulu and Nwoya. RESULTS: The prevalence of major depressive disorder (MDD) was 24.7% (95% CI: 22.9%-26.4%). The distribution by gender was females 29.2% (95% CI: 14.6%-19.5%) and males 17.0% (95% CI: 26.9%-31.5%). The risk factors for MDD fell under the broad domains of socio-demographic factors (female gender, increasing age, being widowed and being separated/divorced); distal psychosocial vulnerability factors ( being HIV positive, low social support, increasing war trauma events previously experienced, war trauma stress scores previously experienced, past psychiatric history, family history of mental illness, negative coping style, increasing childhood trauma scores, life-time attempted suicide, PTSD, generalized anxiety disorder and alcohol dependency disorder) and the psychosocial stressors (food insufficiency, increasing negative life event scores, increasing stress scores). ‘Not receiving anti-retroviral therapy’ for those who were HIV positive was the only negative clinical and behavioral outcome associated with MDD. CONCLUSIONS: These findings indicate that post-conflict northern Uganda still has high rates for MDD. The risk factors are quite many (including psychiatric, psychological and social factors) hence the need for effective multi-sectoral programs to address the high rates of MDD in the region. These programs should be long term in order to address the long term effects of war. Longitudinal studies are recommended to continuously assess the trends of MDD in the region and remedial action taken.
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spelling pubmed-43760712015-03-28 Major depressive disorder seven years after the conflict in northern Uganda: burden, risk factors and impact on outcomes (The Wayo-Nero Study) Mugisha, James Muyinda, Herbert Malamba, Samuel Kinyanda, Eugene BMC Psychiatry Research Article BACKGROUND: Major depressive disorder (MDD) is a major public health burden in conflict areas. However, it is not known for how long and by how much the observed high rates of MDD seen in conflict settings persist into the post-conflict period. METHODS: A cross sectional survey was employed seven years after the conflict in northern Uganda had ended in the three districts of Amuru, Gulu and Nwoya. RESULTS: The prevalence of major depressive disorder (MDD) was 24.7% (95% CI: 22.9%-26.4%). The distribution by gender was females 29.2% (95% CI: 14.6%-19.5%) and males 17.0% (95% CI: 26.9%-31.5%). The risk factors for MDD fell under the broad domains of socio-demographic factors (female gender, increasing age, being widowed and being separated/divorced); distal psychosocial vulnerability factors ( being HIV positive, low social support, increasing war trauma events previously experienced, war trauma stress scores previously experienced, past psychiatric history, family history of mental illness, negative coping style, increasing childhood trauma scores, life-time attempted suicide, PTSD, generalized anxiety disorder and alcohol dependency disorder) and the psychosocial stressors (food insufficiency, increasing negative life event scores, increasing stress scores). ‘Not receiving anti-retroviral therapy’ for those who were HIV positive was the only negative clinical and behavioral outcome associated with MDD. CONCLUSIONS: These findings indicate that post-conflict northern Uganda still has high rates for MDD. The risk factors are quite many (including psychiatric, psychological and social factors) hence the need for effective multi-sectoral programs to address the high rates of MDD in the region. These programs should be long term in order to address the long term effects of war. Longitudinal studies are recommended to continuously assess the trends of MDD in the region and remedial action taken. BioMed Central 2015-03-14 /pmc/articles/PMC4376071/ /pubmed/25881310 http://dx.doi.org/10.1186/s12888-015-0423-z Text en © Mugisha et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Mugisha, James
Muyinda, Herbert
Malamba, Samuel
Kinyanda, Eugene
Major depressive disorder seven years after the conflict in northern Uganda: burden, risk factors and impact on outcomes (The Wayo-Nero Study)
title Major depressive disorder seven years after the conflict in northern Uganda: burden, risk factors and impact on outcomes (The Wayo-Nero Study)
title_full Major depressive disorder seven years after the conflict in northern Uganda: burden, risk factors and impact on outcomes (The Wayo-Nero Study)
title_fullStr Major depressive disorder seven years after the conflict in northern Uganda: burden, risk factors and impact on outcomes (The Wayo-Nero Study)
title_full_unstemmed Major depressive disorder seven years after the conflict in northern Uganda: burden, risk factors and impact on outcomes (The Wayo-Nero Study)
title_short Major depressive disorder seven years after the conflict in northern Uganda: burden, risk factors and impact on outcomes (The Wayo-Nero Study)
title_sort major depressive disorder seven years after the conflict in northern uganda: burden, risk factors and impact on outcomes (the wayo-nero study)
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376071/
https://www.ncbi.nlm.nih.gov/pubmed/25881310
http://dx.doi.org/10.1186/s12888-015-0423-z
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