Outcome of Depression and Anxiety After War: A Prospective Epidemiologic Study of Children and Adolescents

Authors

  • Elie G. Karam,

    Corresponding author
    1. Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
    2. Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
    3. Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
    • Correspondence concerning this article should be addressed to Elie G. Karam, St. George Hospital University Medical Center, IDRAAC Second Floor, Room 208–209, P.O. Box: 166227, Ashrafieh, Beirut, Lebanon 1100 2110. E-mail: egkaram@idraac.org

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  • John Fayyad,

    1. Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
    2. Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
    3. Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
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  • Aimee N. Karam,

    1. Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
    2. Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
    3. Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
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  • Nadine Melhem,

    1. Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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  • Zeina Mneimneh,

    1. Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
    2. Survey Methodology Program, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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  • Hani Dimassi,

    1. School of Pharmacy, Lebanese American University, Byblos, Lebanon
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  • Caroline Cordahi Tabet

    1. Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
    2. Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
    3. Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
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  • This work has been supported by IDRAAC, the Lebanese Ministry of Interior, UNICEF, the Dutch Foreign Ministry, the Hariri Foundation, the Lebanese Research Council, and the Lebanese Ministry of Education.

Abstract

Prospective studies of children exposed to war have not investigated disorders other than posttraumatic stress disorder (PTSD) and have methodological limitations. From a stratified random sample of 386 children and adolescents who had been interviewed 3 weeks after war exposure (Phase 1) a random subsample (N = 143) was interviewed a year later (Phase 2). PTSD, major depressive disorder (MDD), separation anxiety disorder (SAD), overanxious disorder (OAD), and psychosocial stressors were assessed using structured interviews administered to both children and adolescents and their parents. The prevalence of disorders among the 143 at Phase 1 was MDD 25.9%, SAD 16.1%, OAD 28.0%, and PTSD 26.0%, with 44.1% having any disorder. At Phase 2 the prevalence was MDD, 5.6%; SAD, 4.2%; OAD, 0%; and PTSD, 1.4%, with 9.2% having any disorder. Occurrence of disorders at Phase 1 was associated with older age, prewar disorders, financial problems, fear of being beaten, and witnessing any war event (ORs ranged from 2.5 to 28.6). Persistence of disorders to Phase 2 was associated with prewar disorders (OR = 6.0) and witnessing any war event (OR = 14.3). There are implications for detection of at-risk cases following wars by screening for adolescents exposed to family violence, those with prewar disorders, and those who directly witnessed war events to target them for specific interventions.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題:一個前瞻性流行病學研究有關兒童及青少年在戰後抑鬱和焦慮的結果

撮要:戰後兒童的前瞻性研究沒有對創傷後壓力症(PTSD)以外病症作探討,而且研究方法上有限制。分層隨機樣本是386名兒童和青少年在戰後3週面見(階段1),和一個隨機子樣本(n=143)在一年後評估(階段2)。利用結構化面見在兒童/青少年和父母中評估PTSD,重性抑鬱症(MDD),分離焦慮症(SAD),過度焦慮症(OAD)和心理社會壓力。階段1患病率為:MDD 25.9%, SAD 16.1%, OAD 28.0%和PTSD 26.0%,而44.1% 為任何疾病類別。階段2患病率為MDD 5.6%, SAD 4.2%, OAD 0%, 和PTSD 1.4%,而9.2%為任何疾病類別。階段1的精神疾患與經濟問題,恐懼被虐打,和目睹任何戰事 (ORs值域從2.5至28.6) 有相連。階段2持續有病則與戰前疾病(OR=6.0)和目睹戰事(OR=16.1)有關連。結果建議我們可以篩選經歷家庭暴力,戰前已有疾病,和目睹戰事的青少年來識別戰後風險個案,從而提供獨特介入治療。

标题:一个前瞻性流行病学研究有关儿童及青少年在战后抑郁和焦虑的结果

撮要:战后儿童的前瞻性研究没有对创伤后压力症(PTSD)以外病症作探讨,而且研究方法上有限制。分层随机样本是386名儿童和青少年在战后3周面见(阶段1),和一个随机子样本(n=143)在一年后评估(阶段2)。利用结构化面见在儿童/青少年和父母中评估PTSD,重性抑郁症(MDD),分离焦虑症(SAD),过度焦虑症(OAD)和心理社会压力。阶段1患病率为:MDD 25.9%, SAD 16.1%, OAD 28.0%和PTSD 26.0%,而44.1% 为任何疾病类别。阶段2患病率为MDD 5.6%, SAD 4.2%, OAD 0%, 和PTSD 1.4%,而9.2%为任何疾病类别。阶段1的精神疾患与经济问题,恐惧被虐打,和目睹任何战事 (ORs值域从2.5至28.6) 有相连。阶段2持续有病则与战前疾病(OR=6.0)和目睹战事(OR=16.1)有关连。结果建议我们可以筛选经历家庭暴力,战前已有疾病,和目睹战事的青少年来识别战后风险个案,从而提供独特介入治疗。

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