Department of Psychiatry, Hôpital Provincial Général de Référence de Bukavu, Université Catholique de Bukavu, Bukavu, DR, Congo.
Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.
BMC Psychiatry. 2020 Feb 7;20(1):53. doi: 10.1186/s12888-020-2480-1.
Armed conflict in Africa has led to displacement of over 24.2 million people, more than 1.4 million of whom are living in Uganda. Studies show that refugees living in Ugandan refugee settlements are at increased risk for post-traumatic stress disorder. However data on the prevalence of other mental health problems among refugees including depression, anxiety and substance use disorder among refugees in Uganda is lacking. Our aim was to determine the prevalence of post-traumatic stress disorder, its main psychiatric comorbidities and perceived psychosocial needs among refugees in Nakivale refugee camp.
We conducted a cross-sectional survey of refugee camp residents (n = 387) from nine different countries of origin. Psychiatric disorders were assessed using the MINI International Neuropsychiatric Interview (MINI) and perceived needs by the Humanitarian Emerging Settings Perceived Needs Scale (HESPER).
The prevalence of psychiatric disorders was high among refugees as was the level of perceived needs. The most prevalent psychiatric disorders were generalized anxiety disorders (73%), post-traumatic stress disorder (PTSD) (67%), major depressive disorder (58%) and substance use disorders (30%). There was a higher level of comorbidity between PTSD and substance use disorder (OR = 5.13), major depressive disorder (OR = 4.04) and generalized anxiety disorder (OR = 3.27). In multivariate analysis, PTSD was positively associated with the perception of stress as a serious problem (OR = 6.52; P-value = 0.003), safety and protection for women in the community (OR = 2.35; P-value = 0.011), care for family (OR = 2.00; P-value = 0.035) and Place to live in (OR = 1.83; P-value = 0.04). After applying the Bonferroni correction, the perception of stress remained significantly associated with PTSD.
Our findings suggest a strong association between PTSD, its main comorbidities and basic needs in Nakivale refugee camps. Mental health support should include psychological interventions as well as social assistance to improve the health of refugees.
非洲的武装冲突导致超过 2420 万人流离失所，其中超过 140 万人居住在乌干达。研究表明，居住在乌干达难民营的难民患创伤后应激障碍的风险增加。然而，关于包括乌干达难民在内的其他心理健康问题（如抑郁、焦虑和物质使用障碍）的流行率数据却很缺乏。我们的目的是确定纳基瓦莱难民营难民中创伤后应激障碍的流行率、其主要的精神共病和感知到的社会心理需求。
我们对来自九个不同原籍国的难民营居民（n=387）进行了横断面调查。使用 MINI 国际神经精神病学访谈（MINI）评估精神疾病，使用人道主义新兴环境感知需求量表（HESPER）评估感知需求。
难民中的精神疾病患病率很高，感知需求的水平也很高。最常见的精神疾病是广泛性焦虑障碍（73%）、创伤后应激障碍（67%）、重度抑郁症（58%）和物质使用障碍（30%）。创伤后应激障碍与物质使用障碍（OR=5.13）、重度抑郁症（OR=4.04）和广泛性焦虑障碍（OR=3.27）之间的共病率更高。在多变量分析中，创伤后应激障碍与将压力视为严重问题（OR=6.52；P 值=0.003）、社区中妇女的安全和保护（OR=2.35；P 值=0.011）、家庭护理（OR=2.00；P 值=0.035）和居住地（OR=1.83；P 值=0.04）的感知呈正相关。在应用 Bonferroni 校正后，对压力的感知仍然与创伤后应激障碍显著相关。
我们的研究结果表明，纳基瓦莱难民营中创伤后应激障碍、其主要共病和基本需求之间存在强烈关联。心理健康支持应包括心理干预以及社会援助，以改善难民的健康。
