Etats de stress en consultation externe à l’hôpital général de Bangui dans un contexte de conflit arme: étude transversale descriptive

Mpembi, Magloire Nkosi; Lukeba, Thierry; Mayemba, Damien; Massamba, Victoria Kubuta; Nzuzi, Thierry Matonda Ma; Gokara, Symphorien; Vermeiren, Etienne; Lelo, Gilbert Mananga; Miezi, Samuel Mampunza Mampunza ma

doi:10.11604/pamj.2018.29.26.7107

Cited by 6 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With regards to predictors of distress, a systematic review identified age as an important factor for prevalence of posttraumatic stress disorder (PTSD), with a sharp incline in childhood years-peaking at around 25 years-and a decline after 55 years of age (1). A cross-sectional study of patients in a hospital run by Doctors Without Borders (MSF) in Central African Republic (CAR), found high prevalence rates of PTSD (33%), acute stress (17%), insomnia (63%), anxiety (45%), and depression (41%), and identified rape, female gender and high anxiety and depression as the main predictors of stress (2). A study of East-African conflict survivors found that stigmatization was associated with risk of PTSD and diminished likelihood of spontaneous remission (3).…”

Section: Introductionmentioning

confidence: 99%

Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries

Andersen

Rossi

Yabutu

et al. 2020

Front. Public Health

View full text Add to dashboard Cite

Introduction: The International Committee of the Red Cross runs an increasing number of mental health and psychosocial programmes integrated into health facilities in conflict settings across Africa. This study looks at changes in symptoms of psychological distress and impaired functioning among patients supported through such programmes.Material and Methods: Between January and December 2019, 5,527 victims of violence received mental health and psychosocial support in 29 health facilities in Burundi, Central African Republic, Democratic Republic of the Congo, Mali, Nigeria and South Sudan. Symptoms of psychological distress (IES-R or DASS21) and daily functioning (ICRC scale) were assessed before and after the intervention. Logistical regression models were used to measure associations between these symptoms and the other variables.Results: Factors associated with high distress prior to receiving support included age (peaking at 45–54 years), intervening within three months, rape, caretaker neglect, internal displacement, secondary education level and referral pathway. Anxiety levels in particular were higher among victims of violence committed by unknown civilians, the military or armed groups. Low functioning was associated with divorce, grief and violence committed by the military or armed groups. Following the intervention, the vast majority of patients reported reduced psychological distress (97.25% for IES-R and 99.11% for DASS21) and improved daily functioning (93.58%). A linear trend was found between number of individual sessions and reduction in symptoms of distress. Financial losses were associated with less reduction in symptoms of depression and stress.Discussion: To further address the mental health and psychosocial needs of victims of violence, intervening quickly and increasing the number of individual sessions per patient is crucial. This requires proximity—being in the right place at the right time—which is challenging when working in stable health structures. Symptoms of depression should not be overlooked, and financial losses must be addressed in order to holistically meet the needs of victims of violence.

show abstract

Section: Introductionmentioning

confidence: 99%

Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries

Andersen

Rossi

Yabutu

et al. 2020

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Standing out as a particularly debilitating type of violence, rape correlated significantly with high psychological distress prior to MHPSS. This result is consistent with the findings of the recent MSF CAR study (2). The fact that patients who had experienced rape improved as much as average indicates that the intervention in its current form addresses the psychological needs stemming from this type of violence.…”

Section: Rapesupporting

confidence: 90%

Table_1.docx

View full text Add to dashboard Cite

“…High levels of post-traumatic stress were associated with increasing age, primary and secondary education level and female gender . While the first two are not consistent with findings of other studies ( 13 , 15 ), the correlation between female gender and increased likelihood of post-traumatic stress disorder (PTSD), including prolonged duration of PTSD, has been shown both in Western ( 16 ) and Africa ( 17 ) populations.…”

Section: Discussionmentioning

confidence: 58%

Community-Level Mental Health and Psychosocial Support During Armed Conflict: A Cohort Study From the Democratic Republic of the Congo, Mali, and Nigeria

Andersen

Rossi

Hubloue

2022

Front. Public Health

View full text Add to dashboard Cite

IntroductionCommunity-level mental health and psychosocial support (MHPSS) was the first type of MHPSS program launched by the International Committee of the Red Cross (ICRC) back in 2004. Standardized beneficiary-level monitoring was put in place in late 2018. This is the first study to explore whether this type of program correlates, as intended, with reduced psychological distress and increased daily functioning.MethodsBetween December 2018 and June 2020, 6,413 victims of violence received MHPSS through 32 community-level projects in the Democratic Republic of the Congo (DRC), Mali and Nigeria. Symptoms of psychological distress (IES-R or DASS21) and daily functioning (ICRC scale) were assessed before and after the intervention and logistical regression models were used to identify predictors of these symptoms.FindingsVictims of the violence committed by weapon bearers were more likely to show high levels of anxiety prior to MHPSS (aOR 3.51; p < 0.0001). Also, victims of physical violence were more likely to show high levels of stress (aOR 1.49; p < 0.0001), whereas victims who had witnessed physical violence were more like to report high levels of depression (aOR 2.54; p < 0.0001). The most common perpetrators were weapon bearers (76%) and the most common type of violence was rape (46%). Lack of social support stood out as a predictor of both high anxiety (aOR 2.10; p < 0.0001) and post-traumatic stress (aOR 2.04; p < 0.0001) prior to MHPSS. Following MHPSS, the vast majority of beneficiaries reported a reduction in distress on the DASS21 (96.58%) and the IES-R scales (92.70%) as well as an increase of functioning (82.26%). Adherence to group therapy (seven sessions on average) was stronger than adherence to individual therapy (four sessions on average). A linear trend was found between length of treatment and likelihood of reporting reduced symptoms of depression. Having suffered destruction or loss of property or income predicted less improvement of functioning following MHPSS (aOR 0.90; p = 0.044).ConclusionReceiving community-level MHPSS is associated with increased wellbeing among the vast majority of beneficiaries. To further enhance the intended health outcomes, it is recommended to increase the length of treatment per beneficiary (30 days minimum) and address, where relevant, the financial consequences of violence. Also, a longitudinal study is recommended to assess longer-term changes in MHPSS symptoms.

show abstract

Etats de stress en consultation externe à l’hôpital général de Bangui dans un contexte de conflit arme: étude transversale descriptive

Cited by 6 publications

References 17 publications

Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries

Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries

Table_1.docx

Community-Level Mental Health and Psychosocial Support During Armed Conflict: A Cohort Study From the Democratic Republic of the Congo, Mali, and Nigeria

Contact Info

Product

Resources

About