Post-traumatic stress disorder and its temporal relationship with quality of life in war-affected districts of North Shewa Zone, Amhara Region, Ethiopia

Abstract

BACKGROUND: People in war-affected and politically violent areas often experience traumatic events that can lead to long-lasting physical and mental health issues. This study aimed to assess the prevalence of post-traumatic stress disorder (PTSD), identify associated risk factors, and examine its relationship with the quality of life. METHOD: A community-based cross-sectional study was conducted Between April 1 and May 15, 2022, in 812 individuals living in war-affected districts of the North Shewa Zone, Amhara Region, Ethiopia. A multistage sampling technique was employed to select the study subjects. Sociodemographic and pre-existing illness data were collected through face-to-face interviews using a pre-tested instrument. The Post-Traumatic Stress Disorder Checklist (PCL-5) was used to measure the PTSD symptoms and cut-off above 33 was used to identify individuals with PTSD. Health-related quality of life was measured using the World Health Organization's (WHO) Quality of Life-brief version (WHOQOL-BREF) questionnaire. Binary logistic regression analysis was used to identify PTSD associated factors, while the independent T-test was applied to compare the quality of life (QOL). The model's fit was evaluated using the Hosmer-Lemeshow goodness-of-fit test and a p-value of 0.05 was considered statistically significant. RESULT: The prevalence of PTSD was 42.4%. Khat use (AOR = 2.33, 95% CI: 1.33-4.07, p < 0.001), having friends or family who died from mental illness (AOR = 3.91, 95% CI: 1.66-9.20, p < 0.01), conflicts with family, friends or loved ones (AOR = 1.89, 95% CI: 1.18-3.01, p < 0.01), poor social support (AOR = 3.84, 95% CI: 2.53-5.81, p < 0.001), and being coerced into accepting ideas against their will (AOR = 2.04, 95% CI: 1.37-3.03, p < 0.001) were significant factors associated with PTSD. Further, quality of life (QOL) was significantly lower by 0.87 points among individuals with PTSD compared to those without PTSD (t-value = 12.279, p < 0.001). CONCLUSION: About 4 in 10 individuals living in war-affected districts of the North Shewa Zone, Amhara Region experienced PTSD. Avoiding substance use (a negative coping style) and providing psychotherapy that can adequately addresses the community's medical, social, and psychological needs is essential for improving QOL in war-related PTSD.