Saturday, January 30, 2010

War Gives Us PTSD, Depression, and Death

War is hell on the brain: Doctors map psychological disorders in Gaza and the West Bank
By Kathlyn Stone / January 7, 2010

Médecins Sans Frontières/Doctors Without Borders reports that short-term psychotherapy could be an effective treatment in specific psychiatric disorders, especially in children.

Trauma from war and violence has led to a high incidence of psychological disorders in Palestinians living in the Gaza Strip and West Bank.

The international medical nongovernmental organization Médecins Sans Frontières/Doctors Without Borders reports that even short-term psychological support can ease the burden of violence-induced psychiatric disorders, especially in children.

Emmanuelle Espié of the Paris-based Epicentre and colleagues from Médecins Sans Frontières/Doctors Without Borders, along with researchers from four French hospitals shared data collected from Palestinian patients ages 1 year and older referred to the Médecins Sans Frontières psychological care program.

Data was gathered from 1,369 patients (773 from the Gaza strip and 596 from the Nablus area) who received psychological care between January 2005 and December 2008. All patients in the study were clinically assessed by a psychologist or psychiatrist.

The patients were evenly divided between male and female with a median age of 16 years. Among the 1,254 patients for whom full clinical information was available, 23.2 percent had post-traumatic stress disorder (PTSD), 17.3 percent had an anxiety disorder (other than PTSD or acute stress disorder), and 15.3 percent had depression.

PTSD was more frequently identified in children under age 15, while depression was the main symptom observed in adults. Among children under 15, factors significantly associated with PTSD included being witness to murder or physical abuse, receiving threats, and property destruction or loss.

Sixty-five percent of patients took part in individual, short-term psychotherapy, with 30.6 percent requiring psychotropic medication (generally Fluoxetine or Alprazolam) along with counseling.

Following psychotherapy, 82.8 percent of children and 75.3 percent of adults had improved symptoms. Psychological care was conducted principally at the patient's home over a course of 8 to 12 weeks. Children tended to stay in therapy longer and to take part in group therapy sessions more often than adults.

Among patients that showed no improvement or aggravated symptoms at the last session, the main persistent symptoms were sadness (14 percent) and aggressive behavior (12.7 percent).

The study authors concluded, “These observations suggest that short-term psychotherapy could be an effective treatment for specific psychiatric disorders occurring in vulnerable populations, including children, living in violent conflict zones, such as in Gaza strip and the West Bank.”

The study was published in the open access journal International Journal of Mental Health Systems.

(The 48-month epidemiological study was concluding just as Operation Cast Lead was beginning. The intensive three-week military attack by Israel began December 27, 2008. More than 1,400 Palestinians -- 237 combatants and 1,172 non-combatants, including 342 children -- were killed and 5,000 civilians were injured during the air and land assault, according to the human rights organization, Al-Haq. More than 4,000 homes and much of Gaza's infrastructure and buildings were destroyed during the assault.)


International Journal of Mental Health Systems 2009, 3:21doi:10.1186/1752-4458-3-21

'Operation Cast Lead': A Statistical Analysis, August 2009, Al-Haq, the West Bank affiliate of the International Commission of Jurists-Geneva

Source / Flesh and Stone

Thanks to Juan Cole / Fluxed Up World