Angel Desai – Brain Blogger http://brainblogger.com Health and Science Blog Covering Brain Topics Mon, 09 Apr 2018 12:00:43 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.5 Implications of War in Northern Uganda on Mental Health http://brainblogger.com/2007/08/16/implications-of-war-in-northern-uganda-on-mental-health/ http://brainblogger.com/2007/08/16/implications-of-war-in-northern-uganda-on-mental-health/#comments Thu, 16 Aug 2007 16:33:52 +0000 http://brainblogger.com/2007/08/16/implications-of-war-in-northern-uganda-on-mental-health/ Law_Politics.jpgA recent issue of the Journal of the American Medical Association (JAMA) released articles dedicated to the study of conflict, human rights, and international mental health consequences. Some of the most striking papers dealt specifically with the psychological effects of war as well as the implications exposure to violent war crimes have on efforts towards peace building. Theory built off of conventional research has already established the links between external conflict and severe psychological trauma for children as well as adults. (1)

Two of the most poignant studies presented in JAMA address the consequences of the persistent conflict that has taken place since the 1980s between the Lord’s Resistance Army, Ugandan People’s Democratic Army, and the people of Northern Uganda. Internal displacement as a result of constant violence has forced local populations into overcrowded living situations, compromising the the health and safety of many of the country’s citizens. The first of those articles treating this particular subject assessed local interventions on depression and its symptoms among 314 adolescents displaced by war in Northern Uganda. (2) Utilizing locally developed screening tools, researchers studied, among other things, the effectiveness of group psychotherapy and activity-based intervention, measuring the improvement of depression symptoms and scores on anxiety and conduct problem scales. The conclusions drawn from this trial highlighted an improvement among adolescent girls who underwent group interpersonal psychotherapy. Moreover, the study stresses the need for other intervention techniques geared towards adolescent boys with depression.

The second article entitled, “Exposure to War Crimes and Implications for Peace Building in Northern Uganda,” presented a unique and interesting perspective on the challenges of implementing peace measures in a population long exposed to war crimes. The study targeted the prevalence of post-traumatic stress disorder (PTSD) and depression in Northern Uganda. Moreover, it measured the response individuals affected by either PTSD or depression had towards peace initiatives. Using the rates of exposure to trauma and resulting beliefs concerning peace in the region, the authors of the study concluded that, “respondents reporting symptoms of PTSD and depression were more likely to favor violent over nonviolent means to end the conflict.” (3)

Although this post treats both studies in extreme brevity, an underlying message concerning health concerns and war remains discernible. Public health in areas of conflict, crisis, and disaster has long been sidelined in deference to “hard politics.” The implications of these and other areas of research suggest, however, that the relationship between health and conflict must be explored further.

To get a full account of these and other studies, please refer to the Journal of the American Medical Association: August 1, 2007, Vol 298, No. 5.

References

(1) Joanna Santa Barbara. The Psychological Effects of War on Children. War and Public Health. Ed. Barry S. Levy and Victor W. Sidel. Oxford: Oxford University Press. American Public Health Association, 2000.

(2) P. Bolton, J. Bass, T. Betancourt, L. Speelman, G. Onyango, K.F. Clougherty, R. Neugebauer, L. Murray, H. Verdeli. Interventions for Depression Symptoms Among Adolescent Survivors of War and Displacement in Northern Uganda: A Randomized Controlled Trial. Journal of the American Medical Association. Vol. 298, No. 5. August 1, 2007.

(3) P. Vinck, P.N. Pham, E. Stover, H.M. Weinstein, Exposure to War Crimes and Implications for Peace Building in Northern Uganda. Journal of the American Medical Association. Vol. 298, No. 5. August 1, 2007.

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Curb Domestic Violence/Abuse and Slash the Incidence of Mental Disorders http://brainblogger.com/2007/07/21/curb-domestic-violenceabuse-and-slash-the-incidence-of-mental-disorders/ http://brainblogger.com/2007/07/21/curb-domestic-violenceabuse-and-slash-the-incidence-of-mental-disorders/#comments Sun, 22 Jul 2007 06:05:53 +0000 http://brainblogger.com/2007/07/21/curb-domestic-violenceabuse-and-slash-the-incidence-of-mental-disorders/ Psychiatry_Psychology.jpgA new study presented by the World Health Organization points to the international community’s efforts to curb interpersonal violence and its mental and physical consequences. This past week nearly 200 experts on violence prevention assembled in Scotland for “Milestones 2007,” a gathering intended to critically examine advances made since the WHO release of the “World Report on Violence and Health,” in 2002. At the time of its original publication, a portion of this landmark report highlighted the psychological impact of interpersonal violence, supporting emerging research on the long-term, medically-related consequences of violence. This on-going study acts to solidify the link between violent behavior and consequently, mental distress.

One of the significant health problems emphasized during the 2007 gathering is the psychological impact of violent acts. More specifically, issues such as cognitive impairment, depression, anxiety, phobias, and psychosomatic disorders have been documented following instances of child maltreatment and “intimate partner violence.”

A 2004 study also conducted by the WHO, for example, estimated that the lifetime impact of child abuse resulted in 6% of depression cases, 8% of suicide attempts, 10% of panic disorders, and 27% of post-traumatic stress disorders (PTSD). In order to combat these and other health, social, and economic consequences of interpersonal violence, preventative rather than responsive measures were among some of the recommendations made by WHO officials. In response, countries such as Brazil, Jamaica, Malaysia, Mozambique and South Africa have begun to implement “violence-prevention” activities.

While the scope of these measures varies among participating nations, the question of effectiveness remains. The idea that long-term violent behavior affects the mental well-being of its victims remains fairly indisputable. However, “violence” in general remains an intensely sociologically-embedded process that may require further scrutiny beyond WHO-enabled measures.

References

World Health Organization, Governments make progress in interpersonal violence prevention.

World Health Organization, Third Milestones of a Global Campaign for Violence Prevention Report 2007 [PDF].

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WHO Calls for Community Health Services to Address Mental Health Issues http://brainblogger.com/2007/06/12/who-calls-for-community-health-services-to-address-mental-health-issues/ http://brainblogger.com/2007/06/12/who-calls-for-community-health-services-to-address-mental-health-issues/#comments Tue, 12 Jun 2007 20:28:09 +0000 http://brainblogger.com/2007/06/12/who-calls-for-community-health-services-to-address-mental-health-issues/ Anti_Stigmatization.jpgThe conclusion of the WHO’s Global Forum for Community Mental Health in Geneva last month presented a consensus within the organization for the dissemination of a network of community mental health services among its member states. The Forum sought to address a increasing incidence of disorders related to mental health among developing countries in particular.

According to WHO officials, factors such as demographic change, natural disasters, internal and external conflict and socio-economic conditions have afflicted individuals living in the developing world disproportionately in terms of the mental health disorders these elements have engendered. In an unprecedented move, WHO organizers invited people living with mental disorders to the Forum, in an attempt to place a “face” on an issue which has been a focal point for global, social stigmatization.

Before the commencement of this Forum, WHO officials addressed mental health issues in 2001, citing it as an area of public health that has not been adequately confronted by member states. In an attempt to arrive at a resolution for improved worldwide services, the forum examined global models for mental health care, ultimately concluding that a network of community mental health services may provide more effective, and less exclusive services as compared to regional mental hospitals.

Dr. Catherine Le Galès-Camus, Assistant Director-General of WHO’s cluster on Noncommunicable Diseases and Mental Health, stated in a WHO press release,

This topic should matter to everyone, because far too many people with mental disorders do not receive any care. The immediate challenge for low income countries is to use primary health care settings, particularly through community approaches that use low-cost, locally available resources to ensure appropriate care of these disorders… The challenge is to enhance systems of care by taking effective local models and disseminating them throughout a country.

The question that remains is whether this rhetoric will materialize on a local and rural level and more importantly, if these initiatives will prove to be feasible in a global setting.

Reference

World Health Organization. (2007) Community mental health services will lessen social exclusion, says WHO. WHO Media Center Notes.

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