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Findings from the world mental health surveys of civil violence exposure and its association with subsequent onset and persistence of mental disorders

dc.creatorAxinn, William G.es_ES
dc.creatorBruffaerts, Ronnyes_ES
dc.creatorKessler, Timothy L.es_ES
dc.creatorFrounfelker, Rochellees_ES
dc.creatorAguilar-Gaxiola, Sergioes_ES
dc.creatorAlonso, Jordies_ES
dc.creatorBunting, Brendanes_ES
dc.creatorCaldas-de-Almeida, José Migueles_ES
dc.creatorCardoso, Graçaes_ES
dc.creatorChardoul, Stephaniees_ES
dc.creatorChiu, Wai Tates_ES
dc.creatorCía, Alfredoes_ES
dc.creatorGureje, Oyees_ES
dc.creatorKaram, Elie G.es_ES
dc.creatorKovess-Masfety, Vivianees_ES
dc.creatorPetukhova, Maria V.es_ES
dc.creatorPiazza, Marinaes_ES
dc.creatorPosada-Villa, Josées_ES
dc.creatorSampson, Nancy A.es_ES
dc.creatorScott, Kate M.es_ES
dc.creatorStagnaro, Juan Carloses_ES
dc.creatorStein, Dan J.es_ES
dc.creatorTorres, Yolandaes_ES
dc.creatorWilliams, David R.es_ES
dc.creatorKessler, Ronald C.es_ES
dc.creatorWHO World Mental Health Survey Collaboratorses_ES
dc.creatorAl-Hamzawi, Ali
dc.creatorAltwaijri, Yasmin A.
dc.creatorAndrade, Laura Helena
dc.creatorAtwoli, Lukoye
dc.creatorBenjet, Corina
dc.creatorBorges, Guilherme
dc.creatorBromet, Evelyn J.
dc.creatorChatterji, Somnath
dc.creatorDegenhardt, Louisa
dc.creatorde Girolamo, Giovanni
dc.creatorHaro, Josep Maria
dc.creatorHarris, Meredith G.
dc.creatorHinkov, Hristo
dc.creatorHu, Chi-yi
dc.creatorde Jonge, Peter
dc.creatorKaram, Aimee Nasser
dc.creatorKaram, Georges
dc.creatorKazdin, Alan E.
dc.creatorKawakami, Norito
dc.creatorKhaled, Salma
dc.creatorKiejna, Andrzej
dc.creatorMcGrath, John J.
dc.creatorMedina-Mora, María Elena
dc.creatorMoskalewicz, Jacek
dc.creatorNavarro-Mateu, Fernando
dc.creatorNishi, Daisuke
dc.creatorten Have, Margreet
dc.creatorViana, Maria Carmen
dc.creatorVigo, Daniel V.
dc.creatorVladescu, Cristian
dc.creatorWojtyniak, Bogdan
dc.date2023
dc.date.accessioned2025-02-13T16:56:07Z
dc.date.available2025-02-13T16:56:07Z
dc.date.issued2023
dc.identifierJC04DIEP23es_ES
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/8217
dc.identifier.urihttp://doi.org/10.1001/jamanetworkopen.2023.18919
dc.descriptionImportance: Understanding the association of civil violence with mental disorders is important for developing effective postconflict recovery policies. Objective: To estimate the association between exposure to civil violence and the subsequent onset and persistence of common mental disorders (in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV]) in representative surveys of civilians from countries that have experienced civil violence since World War II. Design, setting, and participants: This study used data from cross-sectional World Health Organization World Mental Health (WMH) surveys administered to households between February 5, 2001, and January 5, 2022, in 7 countries that experienced periods of civil violence after World War II (Argentina, Colombia, Lebanon, Nigeria, Northern Ireland, Peru, and South Africa). Data from respondents in other WMH surveys who immigrated from countries with civil violence in Africa and Latin America were also included. Representative samples comprised adults (aged ≥18 years) from eligible countries. Data analysis was performed from February 10 to 13, 2023. Exposures: Exposure was defined as a self-report of having been a civilian in a war zone or region of terror. Related stressors (being displaced, witnessing atrocities, or being a combatant) were also assessed. Exposures occurred a median of 21 (IQR, 12-30) years before the interview. Main outcomes and measures: The main outcome was the retrospectively reported lifetime prevalence and 12-month persistence (estimated by calculating 12-month prevalence among lifetime cases) of DSM-IV anxiety, mood, and externalizing (alcohol use, illicit drug use, or intermittent explosive) disorders. Results: This study included 18 212 respondents from 7 countries. Of these individuals, 2096 reported that they were exposed to civil violence (56.5% were men; median age, 40 [IQR, 30-52] years) and 16 116 were not exposed (45.2% were men; median age, 35 [IQR, 26-48] years). Respondents who reported being exposed to civil violence had a significantly elevated onset risk of anxiety (risk ratio [RR], 1.8 [95% CI, 1.5-2.1]), mood (RR, 1.5 [95% CI, 1.3-1.7]), and externalizing (RR, 1.6 [95% CI, 1.3-1.9]) disorders. Combatants additionally had a significantly elevated onset risk of anxiety disorders (RR, 2.0 [95% CI, 1.3-3.1]) and refugees had an increased onset risk of mood (RR, 1.5 [95% CI, 1.1-2.0]) and externalizing (RR, 1.6 [95% CI, 1.0-2.4]) disorders. Elevated disorder onset risks persisted for more than 2 decades if conflicts persisted but not after either termination of hostilities or emigration. Persistence (ie, 12-month prevalence among respondents with lifetime prevalence of the disorder), in comparison, was generally not associated with exposure. Conclusions: In this survey study of exposure to civil violence, exposure was associated with an elevated risk of mental disorders among civilians for many years after initial exposure. These findings suggest that policy makers should recognize these associations when projecting future mental disorder treatment needs in countries experiencing civil violence and among affected migrants.es_ES
dc.formatPDFes_ES
dc.language.isoenges_ES
dc.publisherAmerican Medical Associationes_ES
dc.relation6(6):e2318919
dc.rightsAcceso Cerradoes_ES
dc.titleFindings from the world mental health surveys of civil violence exposure and its association with subsequent onset and persistence of mental disorderses_ES
dc.typeArtículoes_ES
dc.contributor.affiliationSurvey Research Center, University of Michigan, Ann Arbor
dc.relation.jnabreviadoJAMA NETW OPEN
dc.relation.jnabreviadoJAMA Network Open
dc.identifier.placeEstados Unidos
dc.date.published2023
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.eissn2574-3805
dc.identifier.doi10.1001/jamanetworkopen.2023.18919


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