The association between armed conflict, violence and mental health: a cross sectional study comparing two populations in Cundinamarca department, Colombia

Abstract

BackgroundExposure to violence in general and to armed conflict in particular has been consistently associated with an increased prevalence of mental illness. Colombia has sustained an internal armed conflict for decades and is considered one of the most violent countries in the world. However, certain areas have been more exposed to the conflict than others.MethodsThis is a cross sectional study comparing two communities from different villages in the department of Cundinamarca, Colombia. One, Guasca, was directly impacted by armed conflict. The other one; Guatavita has never been affected by armed conflict. We applied two different instruments: the PHQ scale and a short standardized interview in order to estimate the prevalence of major psychiatric disorders and their link to violent events. Forty-two volunteers from each village were evaluated through a personal interview using these two instruments.FindingsOf the population surveyed in Guatavita, 2.4% reported direct exposure to violence compared to 23.8% from Guasca. In the population exposed directly to violent events, the prevalence of all disorders was greater than in the non-exposed population with an OR of 1.46 (95% CI 0.3809 - 5.5989) for anxiety; 4.54 (95% CI 1.1098 - 18.5984) for depression; 6.0 (95% CI 1.2298 - 30.2263) for somatization disorder; and 4.4 (95% CI 1.2037 - 16.0842) for alcohol abuse.InterpretationThere is a statistically significant association between the history of armed conflict, violence and the presence of mental illnesses, particularly depression, somatization disorder and alcohol abuse. Special attention should be paid to the detection, prevention and treatment of these disorders when dealing with populations exposed to violence and to armed conflict in particular.

Internally Displaced “Victims of Armed Conflict” in Colombia: The Trajectory and Trauma Signature of Forced Migration

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War and Gender Inequalities in Health: The Impact of Armed Conflict on Fertility and Maternal Mortality

“…Also, a study in Colombia found that populations exposed to armed conflict experienced different forms of mental illness, particularly depression, somatization disorder and alcohol abuse (16). Still, another study among women in six conflict-affected areas in the north and east of Sri Lanka found substantially higher rates of early marriage, pregnancy and home births, higher levels of maternal mortality and lower levels of contraceptive use compared to other non-conflict areas (17).…”

Socio-demographic patterns of posttraumatic stress disorder in Medellin, Colombia and the context of lifetime trauma exposure

“…29 Research conducted in Colombia found comparable high rates of somatization disorder in samples drawn from the populations of communities with or without intensive exposure to armed conflict (73% vs. 61%). 30 The incidence of somatic symptoms seems to be related to Hispanics' tendency to see mind, body, and spirit as a continuum and, importantly, individuals with somatization disorder are 3 times more likely to develop PTSD. 14 Furthermore, Latinos tend to experience peri-traumatic dissociation or "altered states of consciousness" during and following traumatic exposure.…”

“…A significant association was observed between exposure to armed conflict and the prevalence of psychiatric disorders while comparing the citizens of Guasca, a Colombian "pueblo" (small town) that had been occupied by the guerrilla and the citizens of Guatavita, a nearby Colombian town where armed conflict never occurred. 30 Bell et al (2012) recently conducted a study in 4 Colombian provinces that had experienced high levels of violence related to the armed conflict.…”