Prevalence of Post-Traumatic Stress, Depression symptoms and Associated Factors in Post-Conflict Areas, North Shoa Zone, Ethiopia: A Community Based Cross Sectional Study

Abstract

Introduction: Post-traumatic stress disorder and depression place an enormous burden on a society that is affected by different traumatic events. People in conflict-affected areas have higher rates of mental disorder symptoms, in particular post-traumatic stress and depressive symptoms, than those usually found in the non-conflict-affected general population. There is scarce evidence in Ethiopia regarding post-traumatic stress and depressive symptoms in residents of conflict-affected areas. Objective: To assess the prevalence of post-traumatic stress disorder, depression and associated factors in post-conflict areas, North Shoa Zone, Amhara, Ethiopia, 2022. Method: A community-based cross-sectional study was conducted from May 24–June 24, 2022 in the North Shoa Zone, Amhara Ethiopia. A multi-stage random sampling method was implemented to select the study participants. An interviewer-administered semi-structured questionnaire was used to collect the data. The Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) was used to measure the symptoms of PTSD; Hopkins' Symptom Checklist-25 (HSCL-25) was also used to assess the symptoms of depression. Epi-data version 4.6 was used to enter data, and SPSS version 25 was used to analyze it. Bi-variable and multivariable logistic regressions with OR and 95% CI were employed to identify statistically significant associated factors for the main outcome variables. During multivariable binary logistic regression analysis, variables with a P-value of less than 0.05 were considered statistically significant. Result: A total of 830 participants were interviewed with a response rate of 96%. The estimated prevalence of PTSD and depression was found to be 63% (95% CI 60–66%) and 66% (95 CI 62%–69%) consecutively. In the multivariable logistic regression, being female (AOR = 4.2, 95% CI (2.82, 6.27)), being unable to read and write (AOR = 3.08, 95% CI (1.67, 5.69)), witnessing the murder of loved ones (AOR = 3.28, 95% CI (1.58, 6.79)), witnessing the murder of strangers (AOR = 2.04, 95% CI (1.33, 3.11)), being verbally threatened or insulted (AOR = 4.09, 95% CI (2.69, 6.21)). Having poor and moderate social support (AOR = 5.26, 95% CI (3.35, 8.28)), (AOR = 1.89, 95% CI (1.15, 3.13)), respectively, was significantly associated with PTSD. Regarding depression, in the multivariable logistic regression, being female (AOR = 2.7, 95% CI (1.89, 4.06)), witnessing the murder of loved ones (AOR = 8.84, 95% CI (3.98 , 19.63)), physical abused (AOR = 2.55, 95% CI (1.36 , 4.78)), ill health without medical care AOR = 1.86, 95% CI (1.03, 3.37)), poor social support (AOR = 2.63, 95% CI (1.63, 4.22)). ii Having moderate and high perceived stress (AOR = 2.14, 95% CI (1.31, 3.51)), (AOR = 7.75, 95% CI (4.42, 13.61)) consecutively were significantly associated. Conclusion: More than half of the dwellers living in conflict-affected areas experienced post-traumatic stress disorder and depression. Being female, being unable to read or write, witnessing the murder of loved ones, witnessing the murder of strangers, being verbally threatened or insulted, and having poor or moderate social support all contributed significantly to post-traumatic stress disorder. Being female, witnessing the murder of loved ones, physical abuse, ill health without medical care, poor social support, moderate and high perceived stress all contributed to the development of depression.