Mental disorders and lack of social support among refugees and Ugandan nationals screening for HIV at health centers in Nakivale Refugee Settlement in southwestern Uganda.

Journal: Journal of global health reports

Volume: 6

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Emergency Medicine, University of Washington, Seattle, Washington, USA. Mbarara University of Science and Technology, Mbarara, Uganda. Department of Global Health, University of Washington, Seattle, Washington, USA. Bugema University, Kampala, Uganda. United Nations High Commissioner for Refugees, Kampala, Uganda. Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda. Public Health Section, Division of Resilience and Solutions, United Nations High Commissioner for Refugees, Geneva, Switzerland. Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.

Abstract summary 

Exposure to potentially traumatic events and daily stressors in humanitarian settings puts refugees and asylum seekers (henceforth collectively referred to as refugees) at increased risk for mental disorders. Little is known about how mental disorder prevalence compares between refugees and national populations who live in the same settings and are exposed to many of the same daily challenges. We aimed to compare the proportions of refugees and Ugandan nationals screening positive for mental disorders in a Ugandan refugee settlement to inform targeted health interventions. Given displacement's disruptive effect on social networks and the importance of social support for mental health, we also aimed to assess social support.Refugees and Ugandan nationals voluntarily testing for HIV at health centers in Nakivale Refugee Settlement were screened for post-traumatic stress disorder (PTSD CheckList-6 - Civilian Version [PCL-6]), depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (General Anxiety Disorder-7 [GAD-7]), and lack of social support (Brief Social Support Scale [BS6]). The association between refugee versus Ugandan national status and the four outcomes was assessed using log-binomial regression.Screening surveys were completed by 5,513 participants, including 3,622 refugees and 1,891 Ugandan nationals. A positive screen for PTSD, depression, anxiety and lack of social support was found for 2,388 (44%), 1,337 (25%), 1,241 (23%) and 631 (12%) participants, respectively. Refugee status was associated with a higher prevalence of a positive screen for PTSD (prevalence ratio [PR] 1.15; 95% confidence interval [CI]: 1.08-1.23), depression (PR: 1.22; 95% CI: 1.11-1.36), anxiety (PR: 1.28; 95% CI: 1.14-1.42), and lack of social support (PR: 1.50; 95% CI: 1.27-1.78). When adjusted for the other outcomes, the higher prevalence of a positive screen for PTSD, anxiety and lack of social support for refugees remained statistically significant.Elevated symptoms of mental disorders are found among refugees and Ugandan nationals testing for HIV in Nakivale Refugee Settlement. The significant association between refugee status and PTSD, anxiety and lack of social support symptoms highlights the distinct needs of this population. To determine the prevalence of mental disorders in these populations, comprehensive assessment, including psychological and neuropsychological testing, is needed.

Authors & Co-authors:  Klabbers Robin E RE Ashaba Scholastic S Stern Joshua J Faustin Zikama Z Tsai Alexander C AC Kasozi Julius J Kambugu Andrew A Ventevogel Peter P Bassett Ingrid V IV O'Laughlin Kelli N KN

Study Outcome 

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Statistics
Citations :  UNHCR. Global Trends - Forced Displacement in 2020. November 8th, 2021. Accessed November 8th, 2021. https://www.unhcr.org/60b638e37/unhcr-global-trends-2020
Authors :  10
Identifiers
Doi : e2022053
SSN : 2399-1623
Study Population
Male,Female
Mesh Terms
Other Terms
PTSD;anxiety;depression;humanitarian context;mental health
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
Scotland