Thapa Suraj Bahadur, Hauff Edvard
Center for Public Health Research and Services, Katmandu, Nepal.
Soc Psychiatry Psychiatr Epidemiol. 2005 Aug;40(8):672-9. doi: 10.1007/s00127-005-0943-9. Epub 2005 Jul 15.
Most internally displaced persons (IDPs) live in low-income countries experiencing a war; their psychosocial health has not been well addressed. We carried out a comprehensive assessment of traumatic experiences, distress symptomatology, and factors independently associated with distress among IDPs in Nepal.
A cross-sectional survey was conducted among 290 IDPs in Nepal during June-July 2003. We used the Hopkins Symptom Checklist-25 (HSCL-25) to assess depression and anxiety symptoms, and the Posttraumatic Stress Disorder (PTSD) Checklist--Civilian Version (PCL-C) to assess PTSD symptoms. All these instruments were validated against local corresponding syndromes and diagnoses of Composite International Diagnostic Interviews (CIDIs) as well.
Almost everyone reported trauma and 53.4% had PTSD symptomatology. The rates of anxiety and depression symptomatology were 80.7 and 80.3%, respectively. Factors independently associated with anxiety symptomatology were illiteracy and feeling miserable on arrival at a new place. Female gender, age 41-50, and feeling miserable on arrival at a new place were associated with depression symptomatology. On the other hand, experiencing greater than three traumatic events and feeling miserable on arrival at a new place were associated with PTSD symptomatology, whereas evacuation after a weeklong preparation and lower caste appeared as protective factors.
High rates of psychological distress and associated factors were identified among highly traumatized IDPs in Nepal, thereby underlining the need for collective assistance, not only for refugees, but also for IDPs. Risk and protective factors that we have identified can thus be utilized for any kind of psychosocial interventions among these IDPs.
大多数国内流离失所者（IDP）生活在经历战争的低收入国家；他们的心理社会健康问题尚未得到妥善解决。我们对尼泊尔境内流离失所者的创伤经历、痛苦症状以及与痛苦独立相关的因素进行了全面评估。
2003年6月至7月期间，对尼泊尔的290名境内流离失所者进行了横断面调查。我们使用霍普金斯症状清单-25（HSCL-25）评估抑郁和焦虑症状，使用创伤后应激障碍清单——平民版（PCL-C）评估创伤后应激障碍症状。所有这些工具也都根据当地相应的综合征以及综合国际诊断访谈（CIDI）的诊断进行了验证。
几乎每个人都报告有创伤经历，53.4%的人有创伤后应激障碍症状。焦虑和抑郁症状的发生率分别为80.7%和80.3%。与焦虑症状独立相关的因素是文盲以及到达新地方时感到痛苦。女性、年龄在41 - 50岁以及到达新地方时感到痛苦与抑郁症状相关。另一方面，经历三次以上创伤事件以及到达新地方时感到痛苦与创伤后应激障碍症状相关，而经过一周准备后撤离以及低种姓则表现为保护因素。
在尼泊尔遭受高度创伤折磨的境内流离失所者中，发现了高比例的心理痛苦及相关因素，这突出表明不仅为难民，也为境内流离失所者提供集体援助的必要性。我们所确定的风险和保护因素因此可用于对这些境内流离失所者进行的任何心理社会干预。
