The Psychosocial Impact of the Kosovo War: A Systematic Review with Recommendations for Kosovar Patient Care

Abstract

Introduction: The Kosovo War is widely remembered as one of the most brutal conflicts in the modern era. With over 13,000 deaths and 90% of the population displaced as refugees, the impact of the war has led to everlasting levels of trauma that impacts the lives of thousands of Kosovar-Albanians today. Objectives: To characterize the psychosocial impact of the Kosovo war by comprehensively assessing the literature to date. We also provide recommendations to improve outcomes for Kosovar-Albanian patients in the post-war era. Methods: A systematic review was conducted using post-war clinical psychological articles on the Kosovo War. Our search involved utilizing full-text English articles from PubMed, OVID Medline, and EMBASE journals. Keywords used were “Kosovo War”, “Psychosocial”, and “Post Traumatic Stress Disorder”. Results: Our post-traumatic stress disorder (PTSD) analysis yielded a total of 10,134 responses from participants ranging from refugees to the general public. Our results showed 2,997 subjects (30%) who reported or met the criteria for post-traumatic stress disorder. When analyzing refugee participants, there was 1,133 with 60% of them meeting the PTSD criteria. In a filtered cohort of 5,117 subjects measured for adverse events, 3,180 subjects (64%) of subjects had experienced combat, while 3,664 (74%) were exiled from their homes. Conclusion: The psychosocial impact of the Kosovo war is likely under-reported by patients due to cultural stigmas, language barriers, and trust barriers with clinicians. Factors such as age, employment, displacement status, number of traumatic events, socioeconomic vulnerability, and health literacy are associated with poor psychiatric morbidity.