Faculty of Health, Education, Medicine, and Social Care, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK.
Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.
BMC Psychiatry. 2019 Mar 4;19(1):83. doi: 10.1186/s12888-019-2064-0.
Experiencing conflict and displacement can have a negative impact on an individual's mental health. Currently, prevalence of mental health disorders (MHDs) at the primary care level in post-conflict areas within the Northern Province of Sri Lanka is unknown. We aimed to explore this prevalence in conflict-affected populations attending primary care, using a structured package of validated screening tools for MHDs.
This cross-sectional study aimed to determine factors related to mental health disorders at the primary care level in Northern Province, Sri Lanka. A structured interview was conducted with internally displaced adults attending 25 randomly selected primary care facilities across all districts of Northern Sri Lanka (Jaffna, Mannar, Mullaitivu, Vavuniya). Participants were screened for depression, anxiety, psychosis, PTSD, and somatoform symptoms.
Among 533 female and 482 male participants (mean age 53.2 years), the prevalence rate for any MHD was 58.8% (95% CI, 53.8-61.4), with 42.4% screening positive for two or more disorders (95% CI, 38.6-46.1). Anxiety prevalence was reported at 46.7% (95% CI, 41.9-51.5), depression at 41.1% (95% CI, 38.7-44.5), PTSD at 13.7% (95% CI, 10.6-16.8), somatoform symptoms at 27.6% (95% CI, 23.6-31.5), and psychosis with hypomania at 17.6% (95% CI, 13.3-21.9).
This is the first study at the primary care level to investigate prevalence of MHDs among conflict-affected populations in the Northern Province, Sri Lanka. Results highlight unmet mental health needs in the region. Training intervention to integrate mental health services into primary care is planned.
经历冲突和流离失所会对个人的心理健康产生负面影响。目前，斯里兰卡北部省冲突地区初级保健水平的心理健康障碍（MHD）患病率尚不清楚。我们旨在使用经过验证的 MHD 筛查工具包，探索在受冲突影响的人群中初级保健中 MHD 的患病率。
本横断面研究旨在确定斯里兰卡北部省初级保健水平与心理健康障碍相关的因素。对 25 个随机选择的初级保健设施中的内部流离失所成年人进行了结构性访谈，这些设施分布在斯里兰卡北部所有地区（贾夫纳、马纳尔、穆莱蒂武、瓦武尼亚）。参与者接受了抑郁、焦虑、精神病、创伤后应激障碍和躯体症状的筛查。
在 533 名女性和 482 名男性参与者中（平均年龄 53.2 岁），任何 MHD 的患病率为 58.8%（95%CI，53.8-61.4%），有 42.4%的人筛查出两种或更多疾病阳性（95%CI，38.6-46.1%）。焦虑症的患病率为 46.7%（95%CI，41.9-51.5%），抑郁症为 41.1%（95%CI，38.7-44.5%），创伤后应激障碍为 13.7%（95%CI，10.6-16.8%），躯体症状为 27.6%（95%CI，23.6-31.5%），精神病伴轻躁狂为 17.6%（95%CI，13.3-21.9%）。
这是在斯里兰卡北部省初级保健水平上首次调查受冲突影响人群中 MHD 患病率的研究。结果突出了该地区未满足的心理健康需求。计划对初级保健中整合心理健康服务进行培训干预。
