Журнал депрессии и тревоги
Открытый доступ
ISSN: 2167-1044
ISSN: 2167-1044
Nishita Pathak
Introduction: Security Force is considered one of the most stressful occupations & Nepal Armed Police Force is no exception. Beside their duty, there are chances being exposed to unexpected stressful situations like riot control, as a rescuer during disaster. They also have family responsibilities, family which can contribute as stress factors. Both family stress & work stress may have cumulative effect on one for having psychological problem. The study was performed to explore the socio-demographic profile of APF patients with anxiety & depression over one year.
Methodology: Becks Depression Inventory & Becks Anxiety Inventory were applied to patient visiting for the first time to OPD along with socio demographic Performa. Patients were categorized to mild, moderate or severe depression or anxiety or mixed type. All participants were aged 18 years or older. Consent was recorded with a signature for literate participants and thumbprint for illiterate participants. Participants did not receive compensation. The Department of Psychiatry at Tribhuvan University Teaching Hospital/Institute of Medicine in Kathmandu provided consultation prior to & during the assessment & gave final approval for the study in 2000. The study in 2007–2008 was approved by the Institutional Review Board of Emory University & the Nepal Health Research Council, with modifications approved by TUTH/IOM. Interviews at both waves of assessment were conducted in participants’ homes with only the interviewer & participant present. Interviews lasted 60–90 min. In 2007–2008, participants with high levels of psychological distress & impaired functioning (58 individuals) were evaluated by the study’s principal investigator. A subset of these was referred for psychosocial care.
Results: 64 patients of anxiety & depressive symptoms were evaluated in which there were 52 (81.3%) patients with anxiety symptoms & 43 (67.2%) patients with depressive symptoms. Majority (45.3%) had served APF for 6-10 years, 50 (78.1%) patients were married & family history was positive in 12 (18.8%) patients. According to BDI scale most patients 15 (23.4%) had mild depressive illness & using BAI majority (34.3%) also had mild anxiety illness. 7 (10.9%) patients had both mild anxiety & depressive symptoms & 3(4.7%) patients had both severe depressive & anxiety symptoms.
Conclusion: Security personnel are in constant level of several stresses which can predispose them to many mental illnesses. Using BDI & BAI questionnaires we tried to analysis the depressive & anxiety symptoms in patients presenting in Armed Police Force Hospital. This information may contribute towards finding etiology & improved management of our patients in future. Mounting evidence suggests that the impact on mental health of war is not inevitable, but rather intimately related to the economic, social & cultural conditions that precede & follow violent conflict. These suppositions are in no way intended to reduce the emphasis placed upon the suffering caused by political violence. Rather, the goal is to increase attention to the equally damaging forces of chronic injustice in the form of ongoing social, financial & health-related threats that erode everyday mental health.
Moreover, pre-conflict marginalization may increase vulnerability to exploitation by militant groups. Maoists used the promise of eradicating social inequities to recruit adults & children into their military. This leads to a final important observation of this study: psychiatric morbidity did not decrease for any demographic group. This challenges suggestions, such as those proffered by rebel revolutionary movements, that violent uprising is a form of psychological emancipation. Ultimately, addressing risk factors for poor mental health such as poverty, lack of education, inadequate healthcare & gender- & ethnic/caste-based discrimination, in addition to trauma healing, may not only ameliorate mental health problems, but also help to reduce vulnerability to exploitation & involvement in political violence.