Roberts Bayard, Damundu Eliaba Yona, Lomoro Olivia, Sondorp Egbert
Conflict and Health Programme, Health Policy Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
BMC Psychiatry. 2009 Mar 4;9:7. doi: 10.1186/1471-244X-9-7.
The signing of the Comprehensive Peace Agreement in January 2005 marked the end of the civil conflict in Sudan lasting over 20 years. The conflict was characterised by widespread violence and large-scale forced migration. Mental health is recognised as a key public health issue for conflict-affected populations. Studies revealed high levels of post-traumatic stress disorder (PTSD) amongst populations from Southern Sudan during the conflict. However, no studies have been conducted on mental health in post-war Southern Sudan. The objective of this study was to measure PTSD and depression in the population in the town of Juba in Southern Sudan; and to investigate the association ofdemographic, displacement, and past and recent trauma exposure variables, on the outcomes of PTSD and depression.
A cross-sectional, random cluster survey with a sample of 1242 adults (aged over 18 years) was conducted in November 2007 in the town of Juba, the capital of Southern Sudan. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association ofdemographic, displacement and trauma exposure variables on the outcomes of PTSD and depression. Multivariate logistic regression was also conducted to investigate which demographic and displacement variables were associated with exposure to traumatic events.
Over one third (36%) of respondents met symptom criteria for PTSD and half (50%) of respondents met symptom criteria for depression. The multivariate logistic regression analysis showed strong associations of gender, marital status, forced displacement, and trauma exposure with outcomes of PTSD and depression. Men, IDPs, and refugees and persons displaced more than once were all significantly more likely to have experienced eight or more traumatic events.
This study provides evidence of high levels of mental distress in the population of Juba Town, and associated risk-factors. Comprehensive social and psychological assistance is urgently required in Juba.
2005年1月《全面和平协议》的签署标志着苏丹持续20多年的内战结束。这场冲突的特点是暴力肆虐和大规模强迫迁移。心理健康被视为受冲突影响人群的一个关键公共卫生问题。研究表明，冲突期间苏丹南部人口中创伤后应激障碍（PTSD）的发生率很高。然而，尚未对战后苏丹南部的心理健康状况进行研究。本研究的目的是测量苏丹南部朱巴镇居民的创伤后应激障碍和抑郁症；并调查人口统计学、流离失所情况以及过去和近期创伤暴露变量与创伤后应激障碍和抑郁症结果之间的关联。
2007年11月在苏丹南部首府朱巴镇对1242名成年人（18岁以上）进行了一项横断面随机整群调查。使用哈佛创伤问卷（原始版本）测量创伤事件暴露水平和创伤后应激障碍水平，使用霍普金斯症状清单-25测量抑郁水平。采用多因素逻辑回归分析人口统计学、流离失所情况和创伤暴露变量与创伤后应激障碍和抑郁症结果之间的关联。还进行了多因素逻辑回归分析，以调查哪些人口统计学和流离失所变量与创伤事件暴露有关。
超过三分之一（36%）的受访者符合创伤后应激障碍的症状标准，一半（50%）的受访者符合抑郁症的症状标准。多因素逻辑回归分析显示，性别、婚姻状况、被迫流离失所和创伤暴露与创伤后应激障碍和抑郁症的结果密切相关。男性、境内流离失所者、难民以及多次流离失所的人经历8次或更多创伤事件的可能性都显著更高。
本研究证明朱巴镇居民存在高度心理困扰，并确定了相关风险因素。朱巴迫切需要全面的社会和心理援助。
