Estimating the prevalence of anxiety, depression and posttraumatic stress disorder in the Kashmir Valley, India

Abstract

Background: The Kashmir Valley has been subject to continual political insecurity and ongoing conflict. We conducted a representative cross-sectional population-based survey of adults to estimate the prevalence and predictors of anxiety, depression and posttraumatic stress disorder (PTSD) in the ten districts of the Kashmir Valley. Methods: We interviewed 5519 out of 5600 invited participants, ?18 years of age, randomly sampled using a probability proportional to size cluster sampling design. We estimated the prevalence of a probable psychological disorder using the Hopkins Symptom Checklist (HSCL-25) and the Harvard Trauma Questionnaire (HTQ-16). Data was weighted to account for the sampling design and multivariate logistic regression analysis was conducted to identify risk factors. Findings: We identified 41% (95% CI 39?2-43?4) of adults with probable depression, 26% (95% CI 23.8-27.5) with probable anxiety and 19% (95% CI 17.5-21.2) with probable PTSD. The three disorders were associated with the following characteristics: being female, over 55 years of age, having had no formal education, living in a rural area, and being widowed/divorced or separated. A dose-response association was found between the number of traumatic events experienced or witnessed and all three mental disorders .Interpretation: The implementation of decentralized mental health awareness programs are needed in the Kashmir Valley.