PTSD – Mental Toll of War Still Costly 20 Years Later

Some villages in Liberia have much higher rates of Post-Traumatic Stress Disorder, PTSD, than others. The villages that were more directly involved in recent wars were much more likely to house villagers suffering from many years of PTSD, even up to 20 years after the major conflicts in the areas ended.

‘Path of mental illness’ follows path of war, 20 years after conflict ends

Researchers at Columbia University’s Mailman School of Public Health assessed the geographical distribution of the long-term burden of Post-Traumatic Stress Disorder (PTSD) in a region of Liberia and report that the prevalence of PTSD remains high nearly two decades after the principal conflict there and five years after war in Liberia ended entirely. Particularly interesting was the geographic distribution of PTSD. Investigators found that certain villages in the region had a much higher prevalence of PTSD than did others. When they compared to the historical record about the path of the violent civil conflict that Nimba County experienced from 1989 to 1990 the team found that these were villages that had experienced the greater burden of war.

“This suggests that there is much more to the aftermath of conflict than a ‘path of blood’ and that populations who are unfortunate enough to have been in the ‘path of trauma’ experiencing severe, violent conflict are likely to bear a burden of psychopathology for decades thereafter,” says Sandro Galea, MD, chair of the Mailman School Department of Epidemiology, and the study’s first author.

The pattern of conflict and psychopathology is even more remarkable, observes Dr. Galea, when considering that so many in the sample were very young during the period of these events and did not themselves experience some of the traumatic events firsthand.

Results of the study are currently online in the American Journal of Public Health.

Overall the study also found a very high prevalence of PTSD. “Our demonstration of a high prevalence of PTSD here is not surprising and is consistent with a recent nationally representative survey in Liberia showing that 44% of respondents in the general population reported symptoms consistent with PTSD,” Dr. Galea said. “We believe that the prolonged and high prevalence of PTSD is consistent with the greater burden of war experienced in Nimba County as compared with some other parts of the country.”

“To put this in perspective, according to the lifetime prevalence of PTSD in the United States, studies suggest that more than one third of all PTSD after traumatic experiences resolves in the first six months after such events,” noted Galea.

The investigators based their findings on a representative survey of the population in post-conflict Nimba County, Liberia, combined with a historical analysis. Following 14 years of civil war in the Republic of Liberia, more than 250,000 lives were lost and more than one-third of the population was displaced.

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About the Mailman School of Public Health

The only accredited school of public health in New York City and among the first in the nation, Columbia University’s Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting millions of people locally and globally. The Mailman School is the recipient of some of the largest government and private grants in Columbia University’s history. Its more than 1000 graduate students pursue master’s and doctoral degrees, and the School’s 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as infectious and chronic diseases, health promotion and disease prevention, environmental health, maternal and child health, health over the life course, health policy, and public health preparedness.

Contact: Stephanie Berger
Source: Columbia University’s Mailman School of Public Health

An old Russion Tank
PTSD is still a major problem for some Liberian villagers even 20 years after the conflicts end. Image:pthread1981 from flickr
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