title: Previous violent events and mental health outcomes in Guatemala.
abstract: OBJECTIVE
  We analyzed a probability sample of Guatemalans to determine if a relationship exists between previous violent events and development of mental health outcomes in various sociodemographic groups, as well as during and after the Guatemalan Civil War.
  
  
  METHODS
  We used regression modeling, an interaction test, and complex survey design adjustments to estimate prevalences and test potential relationships between previous violent events and mental health.
  
  
  RESULTS
  Many (20.6%) participants experienced at least 1 previous serious violent event. Witnessing someone severely injured or killed was the most common event. Depression was experienced by 4.2% of participants, with 6.5% experiencing anxiety, 6.4% an alcohol-related disorder, and 1.9% posttraumatic stress disorder (PTSD). Persons who experienced violence during the war had 4.3 times the adjusted odds of alcohol-related disorders (P < .05) and 4.0 times the adjusted odds of PTSD (P < .05) compared with the postwar period. Women, indigenous Maya, and urban dwellers had greater odds of experiencing postviolence mental health outcomes.
  
  
  CONCLUSIONS
  Violence that began during the civil war and continues today has had a significant effect on the mental health of Guatemalans. However, mental health outcomes resulting from violent events decreased in the postwar period, suggesting a nation in recovery.
authors.affiliation: Victor D. Puac-Polanco is with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Victor A. Lopez-Soto is with the Universidad de San Carlos de Guatemala Facultad de Medicina, Guatemala City. Robert Kohn is with the Department of Psychiatry and Human Behavior, Brown University, Providence, RI. Dawei Xie and Charles C. Branas are with the Department of Biostatistics and Epidemiology, School of Medicine, University of Pennsylvania, Philadelphia. Therese S. Richmond is with the School of Nursing, University of Pennsylvania, Philadelphia.
authors.forename: Victor D
authors.initials: VD
authors.lastname: Puac-Polanco
authors.forename: Victor A
authors.initials: VA
authors.lastname: Lopez-Soto
authors.forename: Robert
authors.initials: R
authors.lastname: Kohn
authors.forename: Dawei
authors.initials: D
authors.lastname: Xie
authors.forename: Therese S
authors.initials: TS
authors.lastname: Richmond
authors.forename: Charles C
authors.initials: CC
authors.lastname: Branas
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006166:Guatemala; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors; D014754:Violence / Q000706:statistics & numerical data*; D014857:Warfare; D055815:Young Adult