Post-traumatic stress, depression, and anxiety during the 2021 Myanmar conflict: a nationwide population-based survey
The UN warns that Myanmar faces the ‘triple crises’ of mass conflict, uncontrolled COVID-19, and economic collapse. Therefore, we aimed to assess the population mental health burden, healthcare needs, and the associated risk factors in Myanmar. We established a nationwide random sample and recruited...
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| Published in: | The Lancet regional health. Southeast Asia Vol. 26; p. 100396 |
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| Main Authors: | , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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England
Elsevier Ltd
01.07.2024
Elsevier |
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| ISSN: | 2772-3682, 2772-3682 |
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| Abstract | The UN warns that Myanmar faces the ‘triple crises’ of mass conflict, uncontrolled COVID-19, and economic collapse. Therefore, we aimed to assess the population mental health burden, healthcare needs, and the associated risk factors in Myanmar.
We established a nationwide random sample and recruited 1038 adults via random digit dialling from July 3–Aug 9, 2021, during the ongoing conflict since Feb 1, 2021, and surge in SARS-CoV-2 infections. Probable post-traumatic stress disorder (PTSD) was assessed using the PTSD Checklist—Civilian Version. Probable depression and anxiety were assessed using the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2. We calculated population attributable fractions for probable mental disorders using multivariable logistic regression models. Based on the mental health burden and healthcare-seeking patterns, we projected the need for mental health services.
During the ‘triple crises’, a third of adults in Myanmar (34.9%, 95% CI 32.0–37.7) reported a probable mental disorder. Prevalence of probable PTSD, depression, and anxiety were 8.1% (6.6–9.7), 14.3% (12.0–16.6), and 22.2% (19.7–24.7), respectively. We estimated that up to 79.9% (43.8–97.9) of probable PTSD was attributable to political stress. This corresponds to 2.1 million (1.1–3.2 million) fewer adults with probable PTSD if political stress was removed from the population. The mental health burden could translate into roughly 5.9 million adults seeking mental health services.
The mental health burden in Myanmar is substantial, and population mental health might only be restored when the three crises have ended. An accelerated peace process is critical to protecting Myanmar’s population mental health.
This research was supported the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. HKU 17606122) and the Michele Tansella Award. |
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| AbstractList | The UN warns that Myanmar faces the 'triple crises' of mass conflict, uncontrolled COVID-19, and economic collapse. Therefore, we aimed to assess the population mental health burden, healthcare needs, and the associated risk factors in Myanmar.BackgroundThe UN warns that Myanmar faces the 'triple crises' of mass conflict, uncontrolled COVID-19, and economic collapse. Therefore, we aimed to assess the population mental health burden, healthcare needs, and the associated risk factors in Myanmar.We established a nationwide random sample and recruited 1038 adults via random digit dialling from July 3-Aug 9, 2021, during the ongoing conflict since Feb 1, 2021, and surge in SARS-CoV-2 infections. Probable post-traumatic stress disorder (PTSD) was assessed using the PTSD Checklist-Civilian Version. Probable depression and anxiety were assessed using the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2. We calculated population attributable fractions for probable mental disorders using multivariable logistic regression models. Based on the mental health burden and healthcare-seeking patterns, we projected the need for mental health services.MethodsWe established a nationwide random sample and recruited 1038 adults via random digit dialling from July 3-Aug 9, 2021, during the ongoing conflict since Feb 1, 2021, and surge in SARS-CoV-2 infections. Probable post-traumatic stress disorder (PTSD) was assessed using the PTSD Checklist-Civilian Version. Probable depression and anxiety were assessed using the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2. We calculated population attributable fractions for probable mental disorders using multivariable logistic regression models. Based on the mental health burden and healthcare-seeking patterns, we projected the need for mental health services.During the 'triple crises', a third of adults in Myanmar (34.9%, 95% CI 32.0-37.7) reported a probable mental disorder. Prevalence of probable PTSD, depression, and anxiety were 8.1% (6.6-9.7), 14.3% (12.0-16.6), and 22.2% (19.7-24.7), respectively. We estimated that up to 79.9% (43.8-97.9) of probable PTSD was attributable to political stress. This corresponds to 2.1 million (1.1-3.2 million) fewer adults with probable PTSD if political stress was removed from the population. The mental health burden could translate into roughly 5.9 million adults seeking mental health services.FindingsDuring the 'triple crises', a third of adults in Myanmar (34.9%, 95% CI 32.0-37.7) reported a probable mental disorder. Prevalence of probable PTSD, depression, and anxiety were 8.1% (6.6-9.7), 14.3% (12.0-16.6), and 22.2% (19.7-24.7), respectively. We estimated that up to 79.9% (43.8-97.9) of probable PTSD was attributable to political stress. This corresponds to 2.1 million (1.1-3.2 million) fewer adults with probable PTSD if political stress was removed from the population. The mental health burden could translate into roughly 5.9 million adults seeking mental health services.The mental health burden in Myanmar is substantial, and population mental health might only be restored when the three crises have ended. An accelerated peace process is critical to protecting Myanmar's population mental health.InterpretationThe mental health burden in Myanmar is substantial, and population mental health might only be restored when the three crises have ended. An accelerated peace process is critical to protecting Myanmar's population mental health.This research was supported the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. HKU 17606122) and the Michele Tansella Award.FundingThis research was supported the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. HKU 17606122) and the Michele Tansella Award. The UN warns that Myanmar faces the ‘triple crises’ of mass conflict, uncontrolled COVID-19, and economic collapse. Therefore, we aimed to assess the population mental health burden, healthcare needs, and the associated risk factors in Myanmar. We established a nationwide random sample and recruited 1038 adults via random digit dialling from July 3–Aug 9, 2021, during the ongoing conflict since Feb 1, 2021, and surge in SARS-CoV-2 infections. Probable post-traumatic stress disorder (PTSD) was assessed using the PTSD Checklist—Civilian Version. Probable depression and anxiety were assessed using the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2. We calculated population attributable fractions for probable mental disorders using multivariable logistic regression models. Based on the mental health burden and healthcare-seeking patterns, we projected the need for mental health services. During the ‘triple crises’, a third of adults in Myanmar (34.9%, 95% CI 32.0–37.7) reported a probable mental disorder. Prevalence of probable PTSD, depression, and anxiety were 8.1% (6.6–9.7), 14.3% (12.0–16.6), and 22.2% (19.7–24.7), respectively. We estimated that up to 79.9% (43.8–97.9) of probable PTSD was attributable to political stress. This corresponds to 2.1 million (1.1–3.2 million) fewer adults with probable PTSD if political stress was removed from the population. The mental health burden could translate into roughly 5.9 million adults seeking mental health services. The mental health burden in Myanmar is substantial, and population mental health might only be restored when the three crises have ended. An accelerated peace process is critical to protecting Myanmar’s population mental health. This research was supported the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. HKU 17606122) and the Michele Tansella Award. |
| ArticleNumber | 100396 |
| Author | Tun, Hein Min Flores, Francis P. Thin Zaw, Phyu Phyu Ni, Michael Y. Chow, Mathew SC Fan, Xiaoyan Lun, Phyllis Leung, Candi MC Ma, Tiffany SW Aung, Yadanar Leung, Gabriel M. Ning, Ke Chang, Wing Chung |
| Author_xml | – sequence: 1 givenname: Xiaoyan surname: Fan fullname: Fan, Xiaoyan organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 2 givenname: Ke surname: Ning fullname: Ning, Ke organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 3 givenname: Tiffany SW surname: Ma fullname: Ma, Tiffany SW organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 4 givenname: Yadanar surname: Aung fullname: Aung, Yadanar organization: Institute for Population and Social Research, Mahidol University, Bangkok, Thailand – sequence: 5 givenname: Hein Min surname: Tun fullname: Tun, Hein Min organization: The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China – sequence: 6 givenname: Phyu Phyu surname: Thin Zaw fullname: Thin Zaw, Phyu Phyu organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 7 givenname: Francis P. orcidid: 0000-0002-3209-0093 surname: Flores fullname: Flores, Francis P. organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 8 givenname: Mathew SC surname: Chow fullname: Chow, Mathew SC organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 9 givenname: Candi MC surname: Leung fullname: Leung, Candi MC organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 10 givenname: Phyllis orcidid: 0000-0002-7652-6450 surname: Lun fullname: Lun, Phyllis organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 11 givenname: Wing Chung surname: Chang fullname: Chang, Wing Chung organization: Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 12 givenname: Gabriel M. surname: Leung fullname: Leung, Gabriel M. organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China – sequence: 13 givenname: Michael Y. orcidid: 0000-0002-1217-5858 surname: Ni fullname: Ni, Michael Y. email: nimy@hku.hk organization: School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38617087$$D View this record in MEDLINE/PubMed |
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| Keywords | COVID-19 Myanmar Conflict Post-traumatic stress disorder Population mental health Depression Anxiety Epidemiology Economic crisis |
| Language | English |
| License | This is an open access article under the CC BY-NC-ND license. 2024 The Author(s). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
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| Snippet | The UN warns that Myanmar faces the ‘triple crises’ of mass conflict, uncontrolled COVID-19, and economic collapse. Therefore, we aimed to assess the... The UN warns that Myanmar faces the 'triple crises' of mass conflict, uncontrolled COVID-19, and economic collapse. Therefore, we aimed to assess the... |
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| SubjectTerms | Anxiety Conflict COVID-19 Depression Economic crisis Epidemiology Myanmar Population mental health Post-traumatic stress disorder |
| Title | Post-traumatic stress, depression, and anxiety during the 2021 Myanmar conflict: a nationwide population-based survey |
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