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Changes in mental disorder prevalence among conflict-affected populations: a prospective study in Sri Lanka (COMRAID-R).

Siriwardhana C, Adikari A, Pannala G, Roberts B, Siribaddana S, Abas M, Sumathipala A, Stewart R - BMC Psychiatry (2015)

Bottom Line: COMRAID-R is a follow-up study of Muslims displaced by conflict from Northern Sri Lanka 20 years ago who are now beginning to return.Common mental disorder (CMD; Patient Health Questionnaire) and post-traumatic stress disorder (CIDI-subscale) were measured.We observed a substantial decrease in CMD prevalence in this population over a short period, which may reflect the prospect of return migration and associated optimism following conflict resolution.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK. chesmal@gmail.com.

ABSTRACT

Background: Longitudinal data are lacking on mental health trajectories following conflict resolution and return migration. COMRAID-R is a follow-up study of Muslims displaced by conflict from Northern Sri Lanka 20 years ago who are now beginning to return.

Methods: Of 450 participants in displacement interviewed in 2011, 338 (75.1%) were re-interviewed a year later, and a supplementary random sample (n = 228) was drawn from return migrants with a comparable displacement history. Common mental disorder (CMD; Patient Health Questionnaire) and post-traumatic stress disorder (CIDI-subscale) were measured.

Results: A CMD prevalence of 18.8% (95%CI 15.2-22.5) at baseline had reduced to 8.6% (5.6-11.7) at follow-up in those remaining in displacement, and was 10.3% (6.5-14.1) in return migrants. PTSD prevalences were 2.4%, 0.3% and 1.6% respectively.

Conclusions: We observed a substantial decrease in CMD prevalence in this population over a short period, which may reflect the prospect of return migration and associated optimism following conflict resolution.

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Related in: MedlinePlus

Sampling methodology flow diagram.
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Fig1: Sampling methodology flow diagram.

Mentions: A multi-stage sampling strategy adopted and used successfully during the baseline study was utilised to recruit the additional sample of returnees (See Figure 1) [16]. This comprised random selection of Grama Niladhari divisions (GNDs; the smallest civil administrative division in Sri Lanka) using government lists from Mannar district, based on probability proportionate to each village population. All selected GNDs were areas of origin for the IDP populations of interest. Ten households of return-migrant families were then randomly selected using government-provided information. Finally, a participant meeting inclusion criteria was randomly selected from each household using the KISH method [18]. The additional sample of returnees recruited at follow-up had thus been living in displacement in Puttalam district for the same length of time, experiencing similar camp/settlement conditions. Earlier return had been possible due to certain areas being cleared of mines earlier, due to their camps being selected by the government for resettlement earlier than others (which was linked to the progress of mine clearing) and due to the step-wise nature of government allocation of land and other resources [14]. In the additional sample of returnees recruited from Mannar for COMRAID-R, the mean number of years since return was 2.2 (SE 0.6; range 0–4).Figure 1


Changes in mental disorder prevalence among conflict-affected populations: a prospective study in Sri Lanka (COMRAID-R).

Siriwardhana C, Adikari A, Pannala G, Roberts B, Siribaddana S, Abas M, Sumathipala A, Stewart R - BMC Psychiatry (2015)

Sampling methodology flow diagram.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4359458&req=5

Fig1: Sampling methodology flow diagram.
Mentions: A multi-stage sampling strategy adopted and used successfully during the baseline study was utilised to recruit the additional sample of returnees (See Figure 1) [16]. This comprised random selection of Grama Niladhari divisions (GNDs; the smallest civil administrative division in Sri Lanka) using government lists from Mannar district, based on probability proportionate to each village population. All selected GNDs were areas of origin for the IDP populations of interest. Ten households of return-migrant families were then randomly selected using government-provided information. Finally, a participant meeting inclusion criteria was randomly selected from each household using the KISH method [18]. The additional sample of returnees recruited at follow-up had thus been living in displacement in Puttalam district for the same length of time, experiencing similar camp/settlement conditions. Earlier return had been possible due to certain areas being cleared of mines earlier, due to their camps being selected by the government for resettlement earlier than others (which was linked to the progress of mine clearing) and due to the step-wise nature of government allocation of land and other resources [14]. In the additional sample of returnees recruited from Mannar for COMRAID-R, the mean number of years since return was 2.2 (SE 0.6; range 0–4).Figure 1

Bottom Line: COMRAID-R is a follow-up study of Muslims displaced by conflict from Northern Sri Lanka 20 years ago who are now beginning to return.Common mental disorder (CMD; Patient Health Questionnaire) and post-traumatic stress disorder (CIDI-subscale) were measured.We observed a substantial decrease in CMD prevalence in this population over a short period, which may reflect the prospect of return migration and associated optimism following conflict resolution.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK. chesmal@gmail.com.

ABSTRACT

Background: Longitudinal data are lacking on mental health trajectories following conflict resolution and return migration. COMRAID-R is a follow-up study of Muslims displaced by conflict from Northern Sri Lanka 20 years ago who are now beginning to return.

Methods: Of 450 participants in displacement interviewed in 2011, 338 (75.1%) were re-interviewed a year later, and a supplementary random sample (n = 228) was drawn from return migrants with a comparable displacement history. Common mental disorder (CMD; Patient Health Questionnaire) and post-traumatic stress disorder (CIDI-subscale) were measured.

Results: A CMD prevalence of 18.8% (95%CI 15.2-22.5) at baseline had reduced to 8.6% (5.6-11.7) at follow-up in those remaining in displacement, and was 10.3% (6.5-14.1) in return migrants. PTSD prevalences were 2.4%, 0.3% and 1.6% respectively.

Conclusions: We observed a substantial decrease in CMD prevalence in this population over a short period, which may reflect the prospect of return migration and associated optimism following conflict resolution.

Show MeSH
Related in: MedlinePlus