title: Trauma and Poor Mental Health in Relation to Economic Status: The Case of Cambodia 35 Years Later.
abstract: BACKGROUND
  Cambodia is one of the poorest countries in south-east Asia and is still emerging from the events of the Khmer Rouge reign. It has been suggested that the atrocities experienced by the Cambodian population can explain why Cambodia continues to lag behind its neighbours in economic outcomes. The purpose of this study is to investigate whether there is an association between exposure to past trauma and/or current poor mental health and current economic status in Cambodia.
  
  
  METHODS
  A newly conducted survey performed in two regions (north-west and south-east Cambodia) collected information on trauma exposure, psychiatric symptoms, self-rated health outcomes and socio-economic information for 3200 persons aged 18-60. Economic outcomes were measured as household debt and poverty status and whether the respondent was economically inactive. All models were analysed using logistic regression.
  
  
  RESULTS
  No association was found between high exposure to conflict-related or civilian trauma and any economic outcomes save for a negative association between civilian trauma and poverty in the south-east. Current post-traumatic stress was related solely to poverty status. All other measures of current mental health status, however, were found to be strongly negatively associated with all measures of economic status. Thus, mental health interventions could potentially be utilised in poverty reduction strategies, but greater efficacy is likely to be achieved by targeting current mental health status rather than previous trauma exposure.
authors: Health Economics Unit, Department of Clinical Science, Lund University, Lund, Sweden; Health Economics & Management, Institute of Economic Research, Lund University, Lund, Sweden.
authors: Johan
authors: J
authors: Jarl
authors: Division of Social Medicine and Global Health, Department of Clinical Science, Lund University, Malmö, Sweden.
authors: Elizabeth
authors: E
authors: Cantor-Graae
authors: Department of Psychiatry, Faculty of Medicine, University of Health Sciences, Phnom Penh, Cambodia.
authors: Thida
authors: T
authors: Chak
authors: Department of Psychiatry, Faculty of Medicine, University of Health Sciences, Phnom Penh, Cambodia.
authors: Ka
authors: K
authors: Sunbaunat
authors: Division of Social Medicine and Global Health, Department of Clinical Science, Lund University, Malmö, Sweden.
authors: Charlotte A
authors: CA
authors: Larsson
mesh_terms: D000328:Adult; D002160:Cambodia; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D014754:Violence / Q000191:economics / Q000523:psychology