title: Clustering of symptoms of mental disorder in the medium-term following conflict: an epidemiological study in Timor-Leste.
abstract: It is important to define subpopulations with mental health and psychosocial reactions in the medium-term following conflict to ensure that an appropriate array of services are provided to meet the diversity of needs. We conducted a latent class analysis (LCA) on epidemiological data drawn from an urban and rural sample of 1221 adults (581 men and 640 women, response 82%) in post-conflict Timor Leste 4 years after the cessation of violence. The prevalence of PTSD was 4.9%; severe distress 4.8%; anger attacks 38.3%; and paranoid-like symptoms 10.9%. The best fitting LCA yielded three classes comprising those with no or minimal symptoms (86%), a class with anger-paranoia (13%) and a comorbid mental disorder class (1.5%) characterized by PTSD (100%) and severe distress (98%). The comorbid mental disorder class had an over-representation of men, the unemployed, residents in the urban area and persons with the greatest exposure to human rights trauma, murder and health stress. The anger-paranoia class experienced moderate levels of trauma and had an over-representation of urban dwellers, women, and those with higher levels of education. The analysis assists in clarifying the populations with mental disorder and adverse psychosocial reactions in need of intervention in the medium-term following conflict.
authors.affiliation: Centre for Population Mental Health Research, Sydney South West Area Health Service and School of Psychiatry, The University of New South Wales, Australia. Electronic address: d.silove@unsw.edu.au.
authors.forename: Derrick
authors.initials: D
authors.lastname: Silove
authors.affiliation: Centre for Population Mental Health Research, Sydney South West Area Health Service and School of Psychiatry, The University of New South Wales, Australia.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Ivancic
authors.affiliation: Centre for Population Mental Health Research, Sydney South West Area Health Service and School of Psychiatry, The University of New South Wales, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Rees
authors.affiliation: Centre for Population Mental Health Research, Sydney South West Area Health Service and School of Psychiatry, The University of New South Wales, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Bateman-Steel
authors.affiliation: Centre for Population Mental Health Research, Sydney South West Area Health Service and School of Psychiatry, The University of New South Wales, Australia.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Steel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology; D012424:Rural Population; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*; D014857:Warfare; D055815:Young Adult
keywords: Conflict and mental disorder; Identification of at-risk populations; latent class analysis; posttraumatic stress