Prevalence of Posttraumatic Stress Disorders among Sample of Internally Displaced Persons in Iraq: A Preliminary Study
Received Date: Feb 06, 2018 / Accepted Date: Mar 19, 2018 / Published Date: Mar 21, 2018
Background: The displacement due to wars and disasters is public problems as the people with displacement exposed to different kinds of traumas, violence, injuries, making them more vulnerable for large scale of psychological disorders such as depression, anxiety, suicidal ideation with attempts and among of these disorders is Posttraumatic stress disorder (PTSD). Iraqi have long bad experiences of wars, sanction and community violence that produced large scale of physical and mental disorders.
Objective: Measuring the effect of displacement on mental health of internally displaced people (IDP) by estimating the prevalence of PTSD.
Methods: Cross-sectional study was done during the January 2016 at major camp for internal displaced people in west of Baghdad-Abu-Graib camp. A convenient sample was obtained and each participant filled a questionnaire that consisted of socio-demographic, in addition to questions of Iraqi version of Harvard Trauma Questionnaire (HTQ) for assessing the PTSD.
Results: 20.8% of the participants had symptoms of PTSD. There was statistically insignificant between gender, marital status education and income with posttraumatic stress disorder symptoms.
Conclusion: High prevalence of PTSD symptoms among internally displaced people (IDP).
Keywords: Posttraumatic stress disorders; Displaced persons; Violence; Iraq
The displacement due to wars and disasters is public health problems as the people with displacement exposed to different kinds of trauma, violence, injuries, making them more vulnerable for large scale of psychological disorders such as depression, anxiety, suicidal ideation with attempts and among of these disorders is posttraumatic disorders (PTSD) that occurred due to witness and or self-exposed to horrible conditions such as murders, threating, kidnapping, loss of relativesfriends, loss of house, starvations [1,2]. The process of migration leads to loss of social role, stress of acculturation, in addition to social isolation .
Posttraumatic stress disorder (PTSD) is the psychiatric disorder that can result from the experience or witnessing of traumatic or lifethreatening events such as terrorist attack, violent crime and abuse, military combat, natural disasters, serious accidents or violent personal assaults .
In Iraq the situation is more complex as the population faced different types of traumas as wars, displacements for decades since Iraqi-Iranian war at 1980, Gulf war 1991 with sanction then US war on Iraq 2003 [1,5]. The condition became more deteriorated after June 2014 when Islamic states of Iraq and Sham (ISIS) occupied many Iraqi governorates including Mosul, Anbar, Salah-al Din and parts of Diyala , leaving hundreds of thousands of internally displaced persons without shelter, medical care or education as more than 1.3 million Iraqis have been confirmed displaced in 2014, in three distinct displacement waves 1) those displaced from the Anbar conflict starting in early January, 2) the Mosul conflict, which began in early June and 3) the Sinjar crisis in which began on 4 August .
The reports that discussed the psychological adverse effects on internally displaced persons (IDP) in Iraq are scarce, so the aim of this study is to estimate the prevalence of PTSD among a sample of IDP in Iraq.
Subjects and Methods
A cross-sectional study was done during the January 2016 at one of major camp for IDP in west of Baghdad-Abu-Graib camp that especially for people who displaced form Anbar.
A convenient sample was obtained which was feasible to the worker and to the general conditions of the displaced persons. Each participant filled a questionnaire that consisted of socio-demographic variables including age, gender, education, marital status, family history of chronic disease, in addition to questions of Iraqi version of Harvard Trauma Questionnaire (HTQ) for assessing the PTSD and Score>2.5 indicates PTSD that meet the criteria of the Diagnostic and Statistical Manual, 4th edition. It has a good internal consistency . The questionnaire was used in Iraq during many previous studies with good reliability and validity .
Verbal consent was obtained from each participant after explanation the aims and concept of the study, the information of those who was illiterate was collected by interview with them. The subjects were given the choice to participate without any reward or penalty.
Data entry followed by descriptive and analytic statistics were performed using the Statistical Package for Social Science (SPSSversion 21) program.
Chi square was used to measure the association between PTSD symptoms and socio-demographical variables and P value<0.05 was considered as a significant association.
Out of total, 67 (87%) was male and 10 (13%) of them was females, married individuals consisted 71.4% of the sample, with mean age of 33.4 ± 9.2 years. 68.5% of the sample had university education.
More than 75% of them lived with income less than 500000 ID (about 350$) per month, Table 1 gives more descriptive data for the sample.
|Missing Total||Total System||77||100|
|Family history of disease||Absent||50||64.9|
|Missing Total||Total System||77||100|
Table 1: Sociodemographic characteristic of the sample.
The results show that 20.8% of the participants had PTSD (Table 2). Prevalence of PTSD among female was 66% while in male was 22%, and there was statistically insignificant association between gender, marital status education level and monthly income with PTSD (Table 3).
Table 2: Frequency of PTSD among the participants.
|Variables||PTSD symptoms||Total||χ2||P value|
Table 3: Relation of PTSD with certain sociodemographic variables.
The literature reveals the rate of PTSD differs among population according to several factors such as age of individuals, type, duration and severity of trauma , in communities that affected by war and forced migration, the prevalence of PTSD ranges between 14 and 37% .
The research showing that the prevalence of PTSD in our region is high as civilians in the Middle East have been subjected to frequent episodes of violence, intra- and inter-group conflicts, and natural disasters , in the Gaza Strip, researchers reported that the lifetime prevalence of PTSD among adults was 17.8% [11-13]. A study that conducted in southern Lebanon reported that (29.3%) of an adult sample met criteria for PTSD , other studies demonstrated a range PTSD from 15.4% to 35.0% among population in Lebanon after the 2006 July War .
The rate of 20.8% among IDP in the current study is lower than prevalence of PTSD among sample of internally displaced youth in Erbil (26.5%)  and lower than what reported in a sample of adolescents in Baghdad (24.7%) , this finding could be attributed to several factors as the differences in regions, age of participants, methods of studies including questionnaires of data collection.
The finding of statistically insignificant association between gender, and PTSD is inconsistent with what reported in the literature as female is more vulnerable for PTSD than male [3,16], this could be due fact that Iraqis was exposed to wide spread violence for long period of time that had bad effect on whole population, as the effects of war include long-term of physical and psychological harm to children and adults [1,17].
High prevalence of PTSD symptoms among internally displaced people as result of exposure to different kinds of traumatic events.
- Murthy SR, Laksh R (2006) Mental health consequences of war: A brief review of research findings. World Psychiatry 5: 25-30.
- Unsworth CG, Goldenberg E (1998) Psychological sequelae of torture and organised violence suffered by refugees from Iraq. Trauma-related factors compared with social factors in exile. Br J Psychiatry 172: 90-94.
- Ahmed SA (2007) Post-traumatic disorders, resilience and vulnerability. Advan Psychiatric Treatment 13: 369-375.
- Iribarren J, Prolo P, Neagos N, Chiappelli F (2005) Post-traumatic stress disorder: Evidence-based research for the third millennium. Evid Based Complement Alternat Med 2: 503-512.
- Neria Y, Bravova M, Halper MJ (2010) Trauma and PTSD among civilians in the middle east. PTSD Research Quarterly 21: 1050-1835
- Shoeb M, Weinstein H, Mollica R (2007) The harvard trauma questionnaire: Adapting a cross-cultural instrument for measuring torture, trauma and post-traumatic stress disorder in Iraqi refugee. Int J soc Psychiatr 53: 447-463.
- Al-Hemiary N, Hashim M T, Alshawi AF, Al Diwan JK (2016) Effect of post-traumatic stress disorder on school achievement among secondary school students in Baghdad, Iraq. Fac Med Baghdad 5: 2-8.
- Karunakara UK, Neuner F, Schauer M, Singh K, Hill K, et al. (2004) Traumatic events and symptoms of post-traumatic stress disorder amongst Sudanese nationals, refugees and Ugandans in the West Nile. African Health Sciences 4: 83-93.
- Sabri R (2017) Post-traumatic stress disorder symptoms resulting from torture and other traumatic events among syrian kurdish refugees in Kurdistan region, Iraq. Front Psychol 8: 241.
- Lafta RK, Aziz ZS, Alobaidi AK (2014) Posttraumatic stress disorder (ptsd) among male adolescents in Baghdad. J Psychol Abnorm Child 3: 121.
- De Jong JTVM, Komproe IH, Van Ommeren M, El Masri M, Araya M, et al. (2001) Lifetime events and posttraumatic stress disorder in 4 post conflict settings. JAMA 286: 555-562.
- Farhood L, Dimassi H, Lehtinen T (2006) Exposure to war-related traumatic events, prevalence of PTSD, and general psychiatric morbidity in a civilian population from southern Lebanon. J Transcult Nurs 17: 333-340.
- Shaar HK (2013) Post-traumatic stress disorder in adolescents in Lebanon as wars gained in ferocity: A systematic review. J Public Health Res 2: e17.
- Tolin DF, Breslau N (2007) Sex difference in risk of PTSD. PTSD research quarterly 18: 1050-1835.
- Al-Nuaimi MA, Hamad RA, Lafta RK (2015) Effects of witnessing or exposure to community violence on mental health of Iraqi men. Qatar Med J.
- Al-Shawi AF, Tawfeeq WA, Dhiaa S, Lafta RK (2017) The impact of violence on Iraqi junior doctors. MOJ Public Health 5: 00115.
- UNICEF Iraq (2016) Violence destroys childhoods in Iraq.
Citation: AlShawi AF (2018) Prevalence of Posttraumatic Stress Disorders among Sample of Internally Displaced Persons in Iraq, A Preliminary Study. J Community Med Health Educ 8: 599. Doi: 10.4172/2161-0711.1000599
Copyright: © 2018 AlShawi AF. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Select your language of interest to view the total content in your interested language
Share This Article
Internatioanl Conference on Community Nursing
September 17-18, 2018 Cape Town, South Africa
International Public Health and Community Nursing Conference
September 19-20, 2018 Singapore City, Singapore
International Conference on Nursing & Healthcare
Oct 31-Nov 01, 2018 New York, USA
27th World Nursing Education Conference
November 12-14, 2018 Frankfurt, Germany
- Total views: 569
- [From(publication date): 0-2018 - Jul 21, 2018]
- Breakdown by view type
- HTML page views: 534
- PDF downloads: 35