title: Perceived needs, self-reported health and disability among displaced persons during an armed conflict in Nepal.
abstract: BACKGROUND
  Most internally displaced persons (IDPs) live in low-income countries and have experienced war. Few studies have assessed their psychosocial needs and disability. We carried out a comprehensive assessment of perceived needs, self-reported health, and disability among IDPs in Nepal and examined factors associated with disability.
  
  
  METHODS
  A cross-sectional survey among 290 IDPs in Nepal was conducted between June and July 2003. We used the World Health Organization's Disability Assessment Schedule-II (WHO-DAS II) with additional local items to assess disability symptoms and a separate checklist to identify their perceived needs. Depression and anxiety symptoms were measured using the Hopkins Symptom Check List (HSCL-25), while the Posttraumatic Stress Disorder Checklist Civilian Version (PCL-C) was used to assess Posttraumatic Stress Disorder (PTSD) symptoms.
  
  
  RESULTS
  Different perceived needs such as financial help (70%), housing (40%), food and education for their children (20%) were expressed by the IDPs. Self-reported health status was strongly associated with distress and disability scores. Factors independently associated with disability were higher age, self-reported health, depression, anxiety but not PTSD. There was good correlation between WHO-DAS II and the locally identified items of disability measurement.
  
  
  CONCLUSIONS
  The reporting of findings only about psychiatric symptoms is insufficient in studying the mental health of displaced and potentially traumatized populations living in low-income countries. Assessments of perceived needs and factors associated with disability give a more comprehensive understanding of the underlying needs among crisis populations, and this can inform intervention programs. Depression and anxiety should be treated effectively to avoid disability.
authors.affiliation: Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. thapasuraj@hotmail.com
authors.forename: Suraj Bahadur
authors.initials: SB
authors.lastname: Thapa
authors.forename: Edvard
authors.initials: E
authors.lastname: Hauff
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D057189:Checklist; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009390:Nepal / Q000453:epidemiology; D011157:Population Dynamics; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014857:Warfare