Stress syndrome, post-traumatic stress disorder, conflict, outpatient care, Central African Republic
Abstract :
[en] Context: in Africa's zones of conflict, recent studies report a high frequency of post-traumatic stress disorder (PTSD) particularly in community settings. Objective: this study aimed to contribute to a better management of patients experiencing violence subsequent to the Central African Republic socio-political conflict. Material and methods: we conducted a cross-sectional study of the medical records of patients receiving outpatient treatment in the Doctors Without Borders/Médecins Sans Frontières (France) Trauma Center, Bangui. Results: 33.33% (n=35) of patients had PTSD, while 17.14% (n=18) of patients had acute stress syndrome. Stress syndrome (SS) was associated with female sex, rape, anxiety and depression. Rape multiplied the risk of SS occurrence by 8. The average age was 30 years (P25:22 years; P75:40 years). The majority of patients had mood disorder (63.81%; n=67). Insomnia was present in 62.83% (n=66) of patients. Hospital Anxiety and Depression Scale (HADS) was present in 44.76 % of patients. Depression was found in 40.95% (n=43) of patients. Conclusion: the obtained results show how the society, apart from militia members, is affected by conflict-related violence in the country. These results can enrich the reflections on health organisation and on the management of patients in Central African, by considering the impact of conflict-related acute stress syndome in the short, medium and long term.
Disciplines :
Psychiatry
Author, co-author :
Matonda Ma Nzuzi ; Université de Liège - ULiège > Doct. sc. bioméd. & pharma. (paysage)
Mpembi, Magloire Nkosi; Université de Kinshasa - UNIKIN > Psychiatrie
Lukeba, Thierry; Université de Kinshasa - UNIKIN > Psychiatrie
Mayemba, Damien; Université de Kinsahsa - UNIKIN > Psychiatrie
(2013) Diagnostic and Statistical Manual of Mental Disorders: Dsm-5, , 5th Revised edition. Washington, DC: American Psychiatric Publishing
Lempérière, T., Féline, A., Adès, J., Hardy, P., Rouillon, F., (2006) Psychiatrie De L'adulte, p. 555. , 2e édition. Issy-les-Moulineaux: Elsevier Masson
Stein, M.B., Walker, J.R., Hazen, A.L., Forde, D.R., Full and partial posttraumatic stress disorder: Findings from a community survey (1997) Am J Psychiatry, 154 (8), pp. 1114-1119. , Aug, PubMed | Google Scholar
Breslau, N., Davis, G.C., Andreski, P., Peterson, E.L., Schultz, L.R., Sex differences in posttraumatic stress disorder (1997) Arch Gen Psychiatry, 54 (11), pp. 1044-1048. , Nov, PubMed | Google Scholar
Johnson, K., Scott, J., Rughita, B., Kisielewski, M., Asher, J., Ong, R., Association of sexual violence and human rights violations with physical and mental health in territories of the Eastern Democratic Republic of the Congo (2010) JAMA, 304 (5), pp. 553-562. , Aug 4, PubMed | Google Scholar
Bayer, C.P., Klasen, F., Adam, H., Association of trauma and PTSD symptoms with openness to reconciliation and feelings of revenge among former Ugandan and Congolese child soldiers (2007) JAMA, 298 (5), pp. 555-559. , Aug 1, PubMed | Google Scholar
Ehler, A., (2012) New Oxford Textbook of Psychiatry. 2Nd édition Oxford, , New York: OUP Oxford, Accessed May 2015
Evans, L., McHugh, T., Hopwood, M., Watt, C., Chronic posttraumatic stress disorder and family functioning of Vietnam veterans and their partners (2003) Aust N Z J Psychiatry, 37 (6), pp. 765-772. , Déc, PubMed |Google Scholar
Holmes, T.H., Rahe, R.H., The social readjustment rating scale (1967) Journal of Psychosomatic Research, 11 (2), pp. 213-218. , Aug, PubMed | Google Scholar
Zigmond, A.S., Snaith, R.P., The hospital anxiety and depression scale (1983) Acta Psychiatr Scand, 67 (6), pp. 361-370. , Jun, PubMed | Google Scholar
Beck, J.G., Grant, D.M., Read, J.P., Clapp, J.D., Coffey, S.F., Miller, L.M., The Impact of Event Scale -Revised: Psychometric properties in a sample of motor vehicle accident survivors (2008) J Anxiety Disord, 22 (2), pp. 187-198. , PubMed | Google Scholar
Mels, C., Derluyn, I., Broekaert, E., Rosseel, Y., Screening for traumatic exposure and posttraumatic stress symptoms in adolescents in the war-affected eastern Democratic Republic of Congo (2009) Arch Pediatr Adolesc Med, 163 (6), pp. 525-530. , Jun, PubMed | Google Scholar
Veling, W., Hall, B.J., Joosse, P., The association between posttraumatic stress symptoms and functional impairment during ongoing conflict in the Democratic Republic of Congo (2013) J Anxiety Disord, 27 (2), pp. 225-230. , Mar, PubMed | Google Scholar
Cohen, M.H., Shi, Q., Fabri, M., Mukanyonga, H., Cai, X., Hoover, D.R., Improvement in posttraumatic stress disorder in postconflict Rwandan women (2011) J Womens Health (Larchmt), 20 (9), pp. 1325-1332. , Sep, PubMed | Google Scholar
Obilom, R.E., Thacher, T.D., Posttraumatic stress disorder following ethnoreligious conflict in Jos, Nigeria (2008) J Interpers Violence, 23 (8), pp. 1108-1119. , Aug, PubMed | Google Scholar
(2015) The CIA World Factbook, 2014, p. 960. , New York. Skyhorse Publishing
de Jong, J.T., Komproe, I.H., van Ommeren, M., El Masri, M., Araya, M., Khaled, N., Lifetime events and posttraumatic stress disorder in 4 postconflict settings (2001) JAMA, 286 (5), pp. 555-562. , Aug 1, PubMed |Google Scholar
Vinck, P., Pham, P.N., Stover, E., Weinstein, H.M., Exposure to war crimes and implications for peace building in northern uganda (2007) JAMA, 298 (5), pp. 543-554. , Aug 1, PubMed | Google Scholar
Roberts, B., Ocaka, K.F., Browne, J., Oyok, T., Sondorp, E., Factors associated with post-traumatic stress disorder and depression amongst internally displaced persons in northern Uganda (2008) BMC Psychiatry, 8, p. 38. , PubMed | Google Scholar