Prevalence of mental disorders and psychological trauma among conflict- affected population in Somalia: a cross-sectional study

Abstract

BackgroundDespite the longstanding psychosocial impact of the interactable conflict in Somalia for the last 30 years, there is lack of epidemiological studies of mental health conditions, especially at the population level.ObjectivesThe aim of this study is to fill the epidemiological gap and provide population based data on mental health conditions in the South-Central region of Somalia. The specific objectives were: (1) To determine the epidemiological patterns of mental disorders in three sites; Baidoa, Dolow and Kismayo, (2) Understand the socio-demographic characteristics associated with mental health conditions in the study sites, and (3) To assess the correlates between psychological trauma and the mental wellbeing of the population.MethodsThis was a cross-sectional study of 713 respondents recruited from the three sites namely Dolow, Baidoa and Kismayo. Data on sociodemographic characteristics and mental disorders were collected using the MINI and sociodemographic questionnaire. Basic descriptive statistics were used to summarize sociodemographic characteristics. Univariable and multivariable logistic regressions were used to examine factors associated with common mental disorders. Statistical significance was considered at a value of p <0.05.ResultsParticipants’ mean age was 32.6 (±10.7) years. More than half (58.5%) of the respondents were male. The overall prevalence of common mental disorders was 557 (78.1%) with panic disorder (39.3%), generalized anxiety disorders (34.9%), major depressive episode current (32.1) and PTSD (29.9%). According to the multivariable logistic regression analysis, being male AOR = 1.74 (95%CI = 1.25, 2.42), having a family size of more than 10 members AOR =1.37 (95% CI = 1.00, 1.89), being unemployed AOR = 1.90 (95%CI = 1.18, 3.06), experienced starvation AOR =3.46 (95%CI = 2.23, 5.37), khat use AOR = 5.87 (955 CI, 1.75–19.65), were identified as predicting factors for the common mental disorders among the study participants.ConclusionThere is a high prevalence of mental disorders with anxiety disorders being the commonest. Findings reflect earlier studies that showed higher rates in conflict and post-conflict settings. It also aligns with past studies in Somalia. As such, there is an urgent need to integrate mental health and psychosocial support within the primary healthcare and other service sectors such as education considering the vast majority of the population are young.

Prevalence and associated factors of common mental disorders among internally displaced people by armed conflict in Cabo Delgado, Mozambique: a cross-sectional community-based study

“…Additionally, the prevalence of anxiety symptoms (40.0%) in the current study was lower than the study done in southwestern Uganda (73%) ( 58 ). On the other hand, the findings of the current study were higher than the study done in northeast Ethiopia (33.4%) ( 56 ), Sweden (31.8%) ( 57 ), Somalia (34.9%) ( 53 ), and Sri Lanka (32.6%) ( 54 ). A possible theory to explain the high prevalence of PTSD, depression, and anxiety symptoms may be the repeated exposure to war attacks and/or violence (previous and current armed conflict, natural disasters, and COVID-19 pandemic) ( 60 ) that these displaced individuals had been exposed to several moments (the last attack in Quissanga district being recorded 6 months before the beginning of the study) ( 61 ).…”

“…The prevalence of PTSD at 74.3% was in line with the study carried out in Uganda (74%) ( 50 ) and lower than a study done in Medellin Colombia (88%) ( 51 ) and Iraq (83.4%) ( 52 ). Contrarily, the estimated PTSD prevalence of the current study was higher than the studies carried out as 63% in Nigeria ( 21 ), 40.8% in northwest and 58.4% in south of Ethiopia ( 24 , 46 ), 19.3% in Morocco ( 22 ), 28% in South Sudan ( 23 ), 29.9% in Somalia ( 53 ) and 7.7% in Sri-Lanka ( 54 ), 46.6% in Bangladesh ( 55 ) particularly among women ( 5 , 24 , 55 , 56 ).…”

“…The prevalence of depression symptoms (63.8%) was higher than the studies carried out in Uganda (58%) ( 58 ), in the south (53.3%) ( 24 ) and North Ethiopia (39.3%) ( 46 ), Sweden (40.2%) ( 57 ), Sri-Lanka (22.2%) ( 54 ) and Somalia (32.1%) ( 53 ). Contrarily, the estimated depression symptoms prevalence of the current study was lower than the study carried out at 89% in Bangladesh ( 59 ).…”

“…The possible explanation for the observed difference could be the difference in tools, in which northwest Ethiopia ( 46 ), and northeast Ethiopia ( 56 ) studies used the post-traumatic stress disorder checklist for DSM (PCL-5), in Sri Lanka and Sweden studies used the Harvard trauma questionnaire (HTQ) ( 54 , 57 ), and in Somalia and Uganda studies were used the International Neuropsychiatric Interview (MINI) ( 53 , 58 ).…”