Gender-based violence in the context of armed conflict in Northern Ethiopia.

BACKGROUND: Gender-based violence (GBV) particularly against women is unfortunately common during armed conflicts. No rigorous and comprehensive empirical work has documented the extent of GBV and its consequences that took place during the two years of devastating armed conflict in Northern Ethiopia. This study aims to assess GBV and its consequences in war-torn areas of northern Ethiopia. METHODS: We used a qualitative method augmented by quantitative method to enroll research participants. We conducted in-depth interviews to characterize the lived experiences of GBV survivors. All interviews were conducted confidentially. The data were collected to the point of data saturation. All interviews were transcribed verbatim into local language, translated into English, and analyzed using a thematic analysis approach. We also used reports from healthcare facilities and conducted a descriptive analysis of the demographic characteristics of study participants. RESULTS: One thousand one hundred seventy-seven persons reported GBV to healthcare providers. The qualitative study identified several forms of violence (sexual, physical, and psychological). Gang rape against women including minors as young as 14 years old girls was reported. Additionally, the perpetrators sexually violated women who were pregnant, and elderly women as old as 65 years, who took refuge in religious institutions. The perpetrators committed direct assaults on the body with items (e.g., burning the body with cigarette fire) or weapons, holding women and girls as captives, and deprivation of sleep and food. GBV survivors reported stigma, prejudice, suicide attempts, nightmares, and hopelessness. GBV survivors dealt with the traumatic stress by outmigration (leaving their residences), seeking care at healthcare facilities, self-isolation, being silent, dropping out of school, and seeking counseling. CONCLUSION: GBV survivors were subjected to multiple and compounding types of violence, with a wide range of adverse health consequences for survivors and their families. GBV survivors require multifaceted interventions including psychological, health, and economic support to rehabilitate them to lead a productive life.

Genetic Risk for Psychiatric Disorders and Telomere Length.

Background: Previous studies have revealed associations between psychiatric disorder diagnosis and shorter telomere length. Here, we attempt to discern whether genetic risk for psychiatric disorders, or use of pharmacological treatments (i.e., antidepressants), predict shorter telomere length and risk for aging-related disease in a United Kingdom population sample. Methods: DNA samples from blood were available from 351 participants who were recruited as part of the South East London Community Health (SELCoH) Study, and for which whole-genome genotype data was available. Leukocyte telomere length was characterized using quantitative polymerase chain reactions. Individualized polygenic risk scores for major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ) were calculated using Psychiatric Genomics Consortium summary statistics. We subsequently performed linear models, to discern the impact polygenic risk for psychiatric disorders (an etiological risk factor) and antidepressant use (common pharmacological treatment) have on telomere length, whilst accounting for other lifestyle/health factors (e.g., BMI, smoking). Results: There were no significant associations between polygenic risk for any of the psychiatric disorders tested and telomere length (p > 0.05). Antidepressant use was significantly associated with shorter telomere length and this was independent from a depression diagnosis or current depression severity (p ≤ 0.01). Antidepressant use was also associated with a significantly higher risk of aging-related disease, which was independent from depression diagnosis (p ≤ 0.05). Conclusion: Genetic risk for psychiatric disorders is not associated with shorter telomere length. Further studies are now needed to prospectively characterize if antidepressant use increases risk for aging-related disease and telomere shortening, or whether people who age faster and have aging-related diseases are just more likely to be prescribed antidepressants.

Sociodemographic, lifestyle, and psychosocial determinants of hair cortisol in a South London community sample.

OBJECTIVE: Hypothalamic-pituitary-adrenal (HPA) measures are crucial for research into stress and stress-related disorders. Most HPA measures fluctuate depending on diurnal rhythms and state confounders. Hair cortisol concentrations (HCC) are less susceptible to such fluctuations, but less is known about trait-like confounders. Using a community sample, we tested the relationship between HCC and a range of variables including demographic variables, hair treatment, and medication, as well as psychosocial variables, namely childhood trauma, critical life events, and depressive symptoms. METHODS: Hair samples were collected from 144 individuals from the South East London Community Health (SELCoH) study. Childhood trauma, life events, and depressive symptoms were measured, together with age, sex, ethnicity, relationship status, educational attainment, employment status, occupational social class, hair washing frequency, hair treatments, season reflected in the hair sample, hazardous drinking, smoking, medication intake, and body mass index. Hair samples reflecting the past 3 months were collected and analysed using immunoassays. First, correlations (continuous variables) and simple linear regressions (dichotomous variables) were conducted to identify sociodemographic, hair-related, and lifestyle determinants of HCC. Next, multiple linear regressions were conducted to test the relationship between psychosocial variables and HCC when controlling for the identified confounders. RESULTS: Age (r=-0.17, p=0.050), White British ethnicity (ß=-0.19, p=0.023), heat-based treatments (ß=-0.22, p=0.010), and winter season (ß=-0.18, p=0.024) were associated with lower HCC, whereas summer season (ß=0.24, p=0.024), painkillers (ß=0.25, p=0.003), anxiolytics/antidepressants (ß=0.21, p=0.014), and hormonal contraceptives (ß=0.27, p=0.006) were associated with higher HCC. Controlling for these confounders, physical neglect during childhood (ß=-0.17, p=0.057), war-related experiences (ß=0.20, p=0.027), separation (ß=0.18, p=0.054), and being the victim of a serious crime (ß=-0.17, p=0.062) were linked with altered HCC. CONCLUSION: Our findings suggest that variation in HCC occurs according to sociodemographic, hair-related, and lifestyle variables, and that certain associations between stress and altered HCC can only be revealed when accounting for these confounders.

Adversity, cannabis use and psychotic experiences: evidence of cumulative and synergistic effects.

BACKGROUND: There is robust evidence that childhood adversity is associated with an increased risk of psychosis. There is, however, little research on intervening factors that might increase or decrease risk following childhood adversity. AIMS: To investigate main effects of, and synergy between, childhood abuse and life events and cannabis use on odds of psychotic experiences. METHOD: Data on psychotic experiences and childhood abuse, life events and cannabis use were collected from 1680 individuals as part of the South East London Community Health Study (SELCoH), a population-based household survey. RESULTS: There was strong evidence that childhood abuse and number of life events combined synergistically to increase odds of psychotic experiences beyond the effects of each individually. There was similar, but weaker, evidence for cannabis use (past year). CONCLUSIONS: Our findings are consistent with the hypothesis that childhood abuse creates an enduring vulnerability to psychosis that is realised in the event of exposure to further stressors and risk factors.

Comparisons of polydrug use at national and inner city levels in England: associations with demographic and socioeconomic factors.

PURPOSE: This study compares polydrug use in national and inner city samples to (1) examine patterns of use underlying different prevalence rates and (2) identify how inner city polydrug use needs targeting in ways not suggested by national research. METHODS: Latent class analyses on indicators of illicit drug use in the last year, hazardous alcohol use, and cigarette smoking were compared between the inner city 2008-2010 South East London Community Health study (n = 1698) and the nationally representative 2007 Adult Psychiatric Morbidity Survey in England (n = 7403). Multinomial logistic regressions then examined latent class solutions with demographic and socioeconomic factors. RESULTS: Both samples revealed three notably similar classes of polydrug users: a "high-drug" group using multiple substances; a "moderate-drug" group using cannabis, alcohol, and cigarettes; and a "low-drug" group reporting minimal alcohol and cigarette use. However, South East London Community Health reported lower risks of polydrug use for ethnic minorities but not for more educated participants. CONCLUSIONS: Despite higher polydrug use prevalence in the inner city, latent classes of polydrug users were similar between samples. Some demographic and socioeconomic factors differed between the samples, suggesting the need for inner city services to use both local and national data for policy planning.