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      Alcohol disorder amongst forcibly displaced persons in northern Uganda

      brief-report

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          Abstract

          Background

          Alcohol use may be a coping mechanism for the stressors related to forced displacement. The aim of this study was to investigate levels and determinants of alcohol disorder amongst internally displaced persons (IDPs) in northern Uganda.

          Methods

          A cross-sectional survey with 1206 adult IDPs was conducted in Gulu and Amuru districts. Alcohol disorder was measured using the AUDIT instrument. Multivariate logistic regression was used to explore demographic, socio-economic, displacement and trauma exposure determinants of alcohol disorder.

          Findings

          The prevalence of probable alcohol disorder was 17% of all respondents, and 66% amongst those who drank alcohol once a month or more frequently. Factors associated with alcohol disorder included men compared to women, older age, and experiencing a higher number of traumatic events. These findings can help identify potentially vulnerable groups and target responses more effectively.

          Research highlights

          ► 80% of sample reported drinking once a month or less (63% men, 91% women). ► 17% of all sample categorised as having alcohol disorder (32% men, 7% women). ► 66% of those drinking >monthly categorised with alcohol disorder (76% men, 47% women). ► Men, older age, and exposure to traumatic events associated with harmful alcohol use.

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          Most cited references16

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          Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda

          Background The 20 year war in northern Uganda between the Lord's Resistance Army and the Ugandan government has resulted in the displacement of up to 2 million people within Uganda. The purpose of the study was to measure rates of post-traumatic stress disorder (PTSD) and depression amongst these internally displaced persons (IDPs), and investigate associated demographic and trauma exposure risk factors. Methods A cross-sectional multi-staged, random cluster survey with 1210 adult IDPs was conducted in November 2006 in Gulu and Amuru districts of northern Uganda. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression were measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association of demographic and trauma exposure variables on the outcomes of PTSD and depression. Results Over half (54%) of the respondents met symptom criteria for PTSD, and over two thirds (67%) of respondents met symptom criteria for depression. Over half (58%) of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. Factors strongly linked with PTSD and depression included gender, marital status, distance of displacement, experiencing ill health without medical care, experiencing rape or sexual abuse, experiencing lack of food or water, and experiencing higher rates of trauma exposure. Conclusion This study provides evidence of exposure to traumatic events and deprivation of essential goods and services suffered by IDPs, and the resultant effect this has upon their mental health. Protection and social and psychological assistance are urgently required to help IDPs in northern Uganda re-build their lives.
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            Common mental disorders in postconflict settings.

            Research into postconflict psychiatric sequelae in low-income countries has been focused largely on symptoms rather than on full psychiatric diagnostic assessment. We assessed 3048 respondents from postconflict communities in Algeria, Cambodia, Ethiopia, and Palestine with the aim of establishing the prevalence of mood disorder, somatoform disorder, post-traumatic stress disorder (PTSD), and other anxiety disorders. PTSD and other anxiety disorders were the most frequent problems. In three countries, PTSD was the most likely disorder in individuals exposed to violence associated with armed conflict, but such violence was a common risk factor for various disorders and comorbidity combinations in different settings. In three countries, anxiety disorder was reported most in people who had not been exposed to such violence. Experience of violence associated with armed conflict was associated with higher rates of disorder that ranged from a risk ratio of 2.10 (95% CI 1.38-2.85) for anxiety in Algeria to 10.03 (5.26-16.65) for PTSD in Palestine. Postconflict mental health programmes should address a range of common disorders beyond PTSD.
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              Alcohol abuse in individuals exposed to trauma: a critical review.

              In this article, the author critically reviews studies on the relationship between exposure to trauma, posttraumatic stress disorder (PTSD), and alcohol abuse. After establishing that strong relationships exist between exposure to traumatic events and alcohol problems, and particularly between the diagnoses of PTSD and alcoholism, the author discusses various factors, theories, and possible mechanisms to account for these associations. Moreover, she discusses applications of these findings to the assessment and treatment of people exposed to trauma who abuse alcohol. Finally, the author outlines novel methods for testing theoretical hypotheses and makes suggestions for methodological improvements in future research.
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                Author and article information

                Journal
                Addict Behav
                Addict Behav
                Addictive Behaviors
                Elsevier Science
                0306-4603
                1873-6327
                August 2011
                August 2011
                : 36
                : 8
                : 870-873
                Affiliations
                [a ]Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
                [b ]Faculty of Medicine, Gulu University, PO Box 166, Gulu, Uganda
                [c ]Department of Epidemiology and Public Health, University College Cork, Ireland
                Author notes
                [* ]Corresponding author. Tel.: + 44 20 79272050. bayard.roberts@ 123456lshtm.ac.uk
                Article
                AB3441
                10.1016/j.addbeh.2011.03.006
                3102180
                21481540
                2486da2a-cb4f-4b99-9638-e864ce753423
                © 2011 Elsevier Ltd.

                This document may be redistributed and reused, subject to certain conditions.

                History
                Categories
                Short Communication

                Clinical Psychology & Psychiatry
                war,alcohol,risk-factors,uganda
                Clinical Psychology & Psychiatry
                war, alcohol, risk-factors, uganda

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