BACKGROUND: The subject of post-conflict mental health lacks studies that are nationally representative or large enough to allow robust examination of levels of distress according to residency in geographical zones of conflict and ethnic minority status. We undertook a nationwide study in @entity3595 Lanka to address these issues. METHODS: We used tablet devices to survey 20   632 @entity1 across 18 of 25 districts in @entity3595 Lanka, of which nine were purposefully selected and nine randomly selected districts. Based on their exposure to war and levels of population displacement, these districts were classified as being in the severe, moderate, or minimal conflict zones. Trained local fieldworkers did private interviews with the @entity1 in the local language; responses were entered directly into the tablet devices. The questions assessed exposure to a wide range of stresses, including ongoing adversities, threat or protection issues, and service access factors, and respondents provided categorical responses (yes/no) to a list of items. We used the 25-item Hopkins Symptom Checklist to measure @entity308 and @entity148 in @entity1 . We used multivariate analysis and calculated population-attributable fractions to estimate potential improvement in mental distress if modifiable factors were addressed. FINDINGS: Our results showed a stepwise increase in symptoms of @entity308 (10%, 33%, 40%) and @entity148 (13%, 23%, 23%) across minimal, moderate, and severe conflict zones, respectively. Membership of an ethnic minority group was associated with @entity308 (Tamil odds ratio [OR] 2  4 [95% CI 1  8-3  1], other ethnic minority OR 2  7 [2  1-3  6]) and @entity148 (Tamil OR 1  5 [1  1-2  0], other ethnic minority OR 1  5 [1  2-1  8]). Other fixed characteristics associated with @entity308 and @entity148 were older age (both @entity308 and @entity148 ; OR 2  7 [95% CI 2  0-3  7] for @entity148 and 2  3 [1  7-3  0] for @entity308 ), being married ( @entity148 only; OR 1  5 [95% CI 1  1-2  1]), and time spent in camps for internally displaced @entity1 ( @entity148 only; @entity16135 [95% CI 1  0-1  9]). Modifiable characteristics were threat or protection issues ( @entity308 @entity20786 [95% CI 1  2-2  8], @entity148 @entity20786 [1  3-2  6]) and scarcity of food ( @entity308 @entity16135 [1  2-1  6], @entity148 @entity16135 [1  2-2  7]), loss of job (OR 1  2 [95% CI 1  2-1  4] for @entity148 ), and proximity to army camps ( @entity13562 [95% CI 1  2-2  2] for @entity308 ). Allaying of safety concerns had the potential to reduce @entity308 by 53% and @entity148 by 57%, with other factors (removal of army camps from proximity and addressing @entity6766 , @entity393 and threat/protection issues) making smaller contributions to a reduction in @entity308 and @entity148 . INTERPRETATION: Our findings offer a basis for detecting high-risk groups and provide directions in devising policies and programmes aimed at alleviating @entity458 in @entity3595 Lanka. Restoration of safety seems to be crucial to mental health recovery. FUNDING: Australian National University-Department of Immigration Border Protection Collaborative Research Program.

Associations of mental distress with residency in conflict zones, ethnic minority status, and potentially modifiable social factors following conflict in XXXX Lanka: a nationwide cross-sectional study.

@entity1 :: ('9606', 'Species') :: ['participants', 'people'] @entity13562 :: ('391109', 'Gene') :: ['OR 1  6'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression'] @entity6766 :: ('MESH:D005517', 'Disease') :: ['food scarcity'] @entity20786 :: ('343406', 'Gene') :: ['OR 1  8'] @entity458 :: ('MESH:D020018', 'Disease') :: ['psychological distress'] @entity3595 :: ('6717', 'Gene') :: ['Sri'] @entity148 :: ('MESH:D001008', 'Disease') :: ['anxiety'] @entity16135 :: ('391107', 'Gene') :: ['OR 1  4'] @entity393 :: ('MESH:D034381', 'Disease') :: ['loss of jobs']
@entity3595 :: (6717,Gene) :: ['Sri']
