title: Long-term psychiatric consequences of exposure to trauma in Cambodia: a regional household survey.
abstract: The long-term psychiatric consequences of exposure to war and/or mass conflict continue to be of great concern and particularly in Cambodia. The current cross-sectional study examined the relationship between history of trauma and current psychiatric and functional morbidity in 3200 randomly selected adults aged 18-60 in Cambodia. Structured interviews were conducted from November 2011 until May 2012 in two predominantly rural regions purposively selected for differing duration of exposure to the Khmer Rouge occupation. Information was also collected regarding ongoing daily stressors and intimate partner violence. Despite high prevalence rates of conflict/war-related trauma, current rates of psychiatric disorders (depression, post-traumatic stress disorder) were relatively low, suggesting that the effects of trauma and extreme hardship in civilian populations may be modified by contextual factors and/or the passage of time. Poor to fair physical health was, however, reported by nearly 60% of the sample. Daily stressors were more important for current morbidity levels than history of trauma, especially in the region with shorter Khmer Rouge occupation. The results suggest that a focus exclusively on past trauma may overlook the contribution of adverse daily life circumstances towards current levels of well-being in civilian populations affected by war and/or mass conflict.
authors.affiliation: Division of Social Medicine and Global Health, Department of Clinical Sciences in Malmö, Lund University, Sweden. Electronic address: elizabeth.cantor-graae@med.lu.se.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Cantor-Graae
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of Health Sciences, Phnom Penh, Cambodia. Electronic address: thida.chak@yahoo.com.
authors.forename: Thida
authors.initials: T
authors.lastname: Chak
authors.affiliation: Department of Psychiatry, Faculty of Medicine, University of Health Sciences, Phnom Penh, Cambodia. Electronic address: kasunbaunat@yahoo.com.
authors.forename: Ka
authors.initials: K
authors.lastname: Sunbaunat
authors.affiliation: Health Economics Unit, Department of Clinical Sciences in Malmö, Lund University, Sweden. Electronic address: johan.jarl@med.lu.se.
authors.forename: Johan
authors.initials: J
authors.lastname: Jarl
authors.affiliation: Division of Social Medicine and Global Health, Department of Clinical Sciences in Malmö, Lund University, Sweden. Electronic address: charlotte_a.larsson@med.lu.se.
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D000328:Adult; D002160:Cambodia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014857:Warfare; D014947:Wounds and Injuries / Q000523:psychology*; D055815:Young Adult
keywords: Cambodia; Conflict; Partner violence; Psychiatric disorder; SF-36; Stress; Trauma; War