title: Comparison of mental health between former child soldiers and children never conscripted by armed groups in Nepal.
abstract: BACKGROUND
  Former child soldiers are considered in need of special mental health interventions. However, there is a lack of studies investigating the mental health of child soldiers compared with civilian children in armed conflicts.
  
  
  OBJECTIVE
  To compare the mental health status of former child soldiers with that of children who have never been conscripts of armed groups.
  
  
  METHODS
  Cross-sectional cohort study conducted in March and April 2007 in Nepal comparing the mental health of 141 former child soldiers and 141 never-conscripted children matched on age, sex, education, and ethnicity.
  
  
  METHODS
  Depression symptoms were assessed via the Depression Self Rating Scale, anxiety symptoms via the Screen for Child Anxiety Related Emotional Disorders, symptoms of posttraumatic stress disorder (PTSD) via the Child PTSD Symptom Scale, general psychological difficulties via the Strength and Difficulties Questionnaire, daily functioning via the Function Impairment tool, and exposure to traumatic events via the PTSD Traumatic Event Checklist of the Kiddie Schedule of Affective Disorders and Schizophrenia.
  
  
  RESULTS
  Participants were a mean of 15.75 years old at the time of this study, and former child soldiers ranged in age from 5 to 16 years at the time of conscription. All participants experienced at least 1 type of trauma. The numbers of former child soldiers meeting symptom cutoff scores were 75 (53.2%) for depression, 65 (46.1%) for anxiety, 78 (55.3%) for PTSD, 55 (39.0%) for psychological difficulties, and 88 (62.4%) for function impairment. After adjusting for traumatic exposures and other covariates, former soldier status was significantly associated with depression (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.31-4.44) and PTSD among girls (OR, 6.80; 95% CI, 2.16-21.58), and PTSD among boys (OR, 3.81; 95% CI, 1.06-13.73) but was not associated with general psychological difficulties (OR, 2.08; 95% CI, 0.86-5.02), anxiety (OR, 1.63; 95% CI, 0.77-3.45), or function impairment (OR, 1.34; 95% CI, 0.84-2.14).
  
  
  CONCLUSIONS
  In Nepal, former child soldiers display greater severity of mental health problems compared with children never conscripted by armed groups, and this difference remains for depression and PTSD (the latter especially among girls) even after controlling for trauma exposure.
authors.affiliation: Department of Anthropology, Emory University, 1557 Dickey Dr, Atlanta, GA 30322, USA. brandonkohrt@gmail.com
authors.forename: Brandon A
authors.initials: BA
authors.lastname: Kohrt
authors.forename: Mark J D
authors.initials: MJ
authors.lastname: Jordans
authors.forename: Wietse A
authors.initials: WA
authors.lastname: Tol
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Speckman
authors.forename: Sujen M
authors.initials: SM
authors.lastname: Maharjan
authors.forename: Carol M
authors.initials: CM
authors.lastname: Worthman
authors.forename: Ivan H
authors.initials: IH
authors.lastname: Komproe
mesh_terms: D000293:Adolescent; D002648:Child; D002669:Child Welfare; D015331:Cohort Studies; D003130:Combat Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008889:Military Personnel / Q000523:psychology*; D009390:Nepal / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014728:Veterans / Q000523:psychology; D014857:Warfare