Risk for Mental Disorders Increased With Exposure to Civil Violence

Elevated disorder onset risks persisted for more than two decades if conflict continued, but did not persist after termination of hostilities

By Elana Gotkine HealthDay Reporter

THURSDAY, June 22, 2023 (HealthDay News) — Exposure to civil violence is associated with an increased risk for mental disorders, according to a study published online June 20 in JAMA Network Open.

William G. Axinn, Ph.D., from the University of Michigan in Ann Arbor, and colleagues estimated the association between exposure to civil violence and the subsequent onset and persistence of common mental disorders. Data were obtained from 18,212 adult respondents to cross-sectional World Health Organization World Mental Health surveys administered in Argentina, Colombia, Lebanon, Nigeria, Northern Ireland, Peru, and South Africa. Exposure was defined as reporting experience as a civilian in a war zone or region of terror, with related stressors assessed as well.

Of those surveyed, 2,096 reported having been exposed to civil violence and 16,116 were not exposed. The researchers found that those who reported being exposed to civil violence had a significantly increased onset risk of anxiety, mood, and externalizing disorders (risk ratios, 1.8, 1.5, and 1.6, respectively). In addition, combatants had a significantly elevated risk for anxiety disorder onset (risk ratio, 2.0), while an increased risk for mood and externalizing disorders onset was seen for refugees (risk ratios, 1.5 and 1.6, respectively). If conflicts persisted, elevated disorder onset risks persisted for more than two decades, but they did not persist after termination of hostilities or emigration. Among lifetime cases, the 12-month persistence of disorders was not tied to preonset history of exposure to civil violence.

“Our finding of elevated disorder onset risk is not surprising, but it is useful to know for service planning purposes that this risk was especially high among people first exposed during their youth, that this onset risk continued for many years among people living in countries that continued to have civil violence, that onset risk declined after the termination of hostilities and after emigration, and that disorder persistence was largely not associated with these factors,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.