06-09-2012, 04:05 PM
Life in conflict: Characteristics of Depression in Kashmir
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Introduction
Mental, physical and social health, are vital
strands of life that are closely interwoven
and deeply interdependent. Depression is
more likely following particular classes of
experience – those involving conflict,
disruption, losses and experiences of
humiliation or entrapment. World Health
Organization has ranked depression as the
fourth among the list of the most urgent
health problems worldwide and has
predicted it to become number two in terms
of disease burden by 2020 overriding
diabetes, cancer, arthritis etc.
The magnitude, suffering and burden in
terms of disability and costs for individuals,
families and societies are staggering (1-3).
Mental disorders are universal, affecting
people of all countries and societies,
individuals at all ages, women and men, the
rich and the poor, from urban and rural
environments. Mental functioning is
fundamentally interconnected with physical
and social functioning and health outcomes
(4,5). The mental health is influenced by
displacement through conflict and war, by
stresses on families, and by economic
adversity. For the many persons who face
uncertain futures (including those by conflict
or disasters), the burden of serious
emotional and behavioural disorders afflicts
their lives. Many people living amidst the
rages of conflict suffer from post-traumatic
stress disorder (6,7).
Results
The results reveal that the prevalence of
depression is 55.72%. The prevalence is
highest (66.67%) in the 15 to 25 years age
group followed by 65.33 % in the 26 to 35
years age group. Females have an overall
prevalence of 60 per cent while as males have
51.34 per cent. Significant difference in the
prevalence of depression among males and
females is in the age group of 36 to 45 years
and 46 to 55 years who have p values of 0.005
and 0.013 respectively. Females have a higher
prevalence of depression in all the age groups
than males and it is highest in the age group
26 to 35 years (68.66%). Females in the age
group of 15-25 years also have similar
prevalence rate of depression (68.64%). In
males prevalence of depression is highest in
the age group of 15-25 years (64.61%)
followed by 62.65% in the age group of 26 to
35 years (62.65%). (Table 3, 4).
Discussion
Traumatic events can have a profound
and lasting impact on the emotional, cognitive,
behavioral and physiological functioning of an
individual. No age group is immune from
exposure to trauma, and its consequences.
The effects of trauma in terms of
psychopathology are well understood in the
case of adults, while as in the case of children
they have only recently begun to be
understood. In a turmoil situation, civilian
casualties have been found to outnumber
military casualties by 3:1 (14). The most
common traumatic event experienced is
witnessing the killing of a close relative,
followed by witnessing the arrest and torture of
a close relative.
Conclusion
Due to continuing conflict in Kashmir
during the last 18 years there has been a
phenomenal increase in psychiatric morbidity.
The prevalence of depression is 55.72%.
Mental health is an integral part of
overall health and quality of life. Effective
evidence-based programs and policies are
available to promote mental health,
enhance resilience, reduce risk factors,
increase protective factors, and prevent
mental and behavioural disorders.
Innovative community-based health
programmes which are culturally and
gender appropriate and reaches out to all
segments of the population need to be
developed. Substantial and sustainable
improvements can be achieved only when a
comprehensive strategy for mental health
which incorporates both prevention and
care elements is adopted.