Mental health of children from a war affected border village: a cross sectional comparative study

Abstract

Background Sri Lankan government had a war against terrorism for thirty years in North and East of Sri Lanka. There were villages in the North-East border that the LTTE held territory and the community living in those villages faced frequent attacks during those three decades. The present study was conducted to compare the mental health of children in a war affected border village, with the mental health of same aged children from a village not directly affected by the war.   Methods Grade 8 and 9 students (n=148) from a government school were selected as subjects and a self-administered questionnaire and the validated Sinhalese version of the Strengths and Difficulties Questionnaire (SDQ) were completed. Age matched 138 students were selected as the comparison group, from an area which is socioeconomically similar but not affected by the war as a border village. Same questionnaires were completed by the comparison group.   Results Subject group consisted of 76 (51%) males and 72 (49%) females. Age ranged from 12-16 years (median 14, IQR 13-14). Majority (n=85, 57.0%) of children living in the border village experienced some kind of an extremely terrifying incident related to the war. Nearly one fifth (n=26, 17.6%) living in the border village, had lost at least one immediate family member due to terrorist attacks. Majority of the border village children (n=94, 63.5%) believed that the war produced a significant negative impact on their lives. Children living in the border village showed 2.5 fold excess risk for a mental health problem (OR 2.5, 95% CI 1.4 to 4.5.   Living in a border village carried 3 times excess risk for conduct problems (OR 3.1, 95% CI 1.6 to 6.0). Children living in the border village showed 2 fold excess risk for peer relationship problems (OR 1.9, 95% CI 1.1 to 3.2). Living in a border village carried 2 fold excess risk for hyperactivity/inattention problems (OR 2.3, 95% CI 1.2 to 4.2).  Conclusions Majority of the children living in border village reported different exposures related to the civil war that can cause considerable and long-lasting psychological impact. Children from the border village had a significantly higher risk of showing borderline abnormal values on the SDQ, compared to children not from a border village. It is probable that this is due to the effect of war and its impact on the mental health of the children of the border village.