BackgroundPost-traumatic stress disorder (PTSD) has considerable and persistent effects on survivors of war, particularly in postconflict areas. Yet, evidence on what keeps survivors on the path of PTSD remains scarce.AimsThe current study aimed to assess the prevalence and correlates of PTSD symptoms among the war-affected population in northern Uganda.MethodsData from 476 war-affected youths (aged 20–27 years) who had participated in a longitudinal cohort study were analysed to describe the enduring associations of background and postwar environmental risk factors with PTSD symptoms. The Impact of Event Scale-Revised was used to evaluate symptoms of PTSD. Descriptive statistics were used to compute background and postwar environmental correlates. Binary logistic regression analyses were fitted to assess the magnitude of the effects of the correlates on PTSD symptoms.ResultsBackground and postwar environmental factors (eg, sexual abuse and injury in captivity) were significantly associated with PTSD symptoms. Postwar environmental factors associated with PTSD symptoms included postwar hardships, stigma/discrimination, chronic illness, community relations, family acceptance and general functioning, among others. The odds ratios (ORs) for post-war hardships were 2.41 (95% confidence interval (CI): 1.63 to 3.56) and 2.90 (95% CI: 2.03 to 4.14) for high and severe PTSD, respectively. For stigma/discrimination, compared with higher scores, the ORs were 3.38 (95% CI: 2.22 to 5.17) and 4.12 (95% CI: 2.69 to 6.30) for high and severe PTSD symptoms, respectively.ConclusionsBackground and postwar environmental stressors exacerbate the severity of PTSD symptoms in survivors of war and should form the basis for interventions to alleviate the toxic effects of war on survivors.

BackgroundDepression represents a significant mental health problem (MHP) in low- and middle-income countries (LMICs), especially among early adults. Nevertheless, most early adults with depression do not seek treatment. Failure to recognize depression and knowledge about mental health literacy (MHL) may contribute to poor help-seeking behavior. This study assessed MHL, access and barriers to mental health care for depression among early adults in Uganda.MethodsData were collected from students in two of the largest universities in Uganda. Participants completed questionnaires on depression, MHL, sources of barriers and opportunities for MH service. Regression analyses and parametric tests were used to assess depression, access, barriers and opportunities to promote MH.ResultsAbout 12 per cent (n = 56) of the respondents were at the level of moderately severe to severe depression. Mental health literacy (MHL) scores were generally low ranging from “Ability to recognize mental disorders” (mean = 19.32, SD 3.22, range 18–32), and “Knowledge of risk factors” (mean = 4.39, SD 1.17, range 2–8), and “Knowledge of available information” (mean = 9.59, SD 2.53, range 5–20). Respondents reported barriers such as “stigma/discrimination” (65.53%), “lack of knowledge of where to receive help” (65.15%), “lack of trust in health workers” (62.56%), and “distant health facilities” (19.70%) that impede access to treatment and care. MHL significantly predicted depression (based on a continuous scale) (β = 0.63, 95% confidence interval [CI]: [0.56, 0.70]) with the regression model yielding a significant fit [R2 = 0.40, F (2, 460) = 189.84, p < 0.001].ConclusionsMHL is low among university students amidst several barriers such as stigma, fear, and lack of trust. To attenuate the negative effects of MHPs on wellbeing and lower the increased risk of psychopathology into adulthood, it is critical to prioritize MHL, address barriers to treatment and care, and develop the requisite infrastructure to tackle depression among early adults.

Drug use among young people is increasing in Africa. To prevent drug use, it is essential to understand the motivations, environments, and characteristics of users. Although there are established risk factors for drug use, little is known about the reasons why adolescents and young people take drugs. This study investigated the reasons given by a sample of secondary school pupils for using drugs and other substances, specifically, how adolescents circumvent the restrictive and prohibitive policy regime and rationalize and account for drug use. This study used a cross-sectional mixed-methods design. For quantitative data, descriptive and regression analyses were run, and for qualitative data, thematic analysis was used. About 13 per cent (n=41) met criteria for moderate to severe drug use. Coping (Mean = 4.13, SD 0.89), social (Mean = 3.71, SD 0.97), and enhancement (Mean = 3.09, SD 0.92) motives were highly endorsed as motives for drug use. The extent to which motives predicted drug use ranged from β = 0.55 (95% CI: 0.39, 0.72) for coping to β = 0.18 (95% CI: 0.08, 0.28) for expansion motives. Students employed ingenious and frequently risky ways to circumvent the rigorous and prohibitive regulatory regimes governing drug use in schools. Academic stress, limited recreational activities, poor stress management, peer influence, poor adult supervision and dysfunctional family backgrounds, all interrelate in complex ways with motives, contexts, and student characteristics to create a conducive environment for the rationalisation, medicalisation, and veneration of drug use. Further research on contexts, motives and characteristics of adolescents that shape drug use is needed.