Abstract
In recent years, the number of refugees and internally displaced persons (IDPs) has dramatically grown worldwide. We aimed to examine psychological distress and its association with sleep and stress in two groups of IDPs with different lengths of displacement in comparison with the general population. Forty-five individuals displaced in 2008, 2.5 months before this study (2008 IDPs), 67 respondents displaced in 1993 (1993 IDPs), and 53 individuals from Tbilisi general population were assessed. All study participants completed the Insomnia Severity Index (ISI), Perceived Stress Scale (PSS) and Brief Symptom Inventory (BSI). Sociodemographic information such as age, sex, education level and marital status was collected. The groups differed significantly on age, education, marital status, ISI, PSS, and Global Severity Index (GSI). The highest ISI and PSS scores were found for the 2008 IDPs, while the highest GSI score - in 1993 IDPs. The GSI and PSS scores did not differ between the two groups of IDPs. The proportion of people with a GSI T score ≥63 was 47.2% in the general population, 71.6% in the 1993 IDPs, and 64.4% in the 2008 IDPs. The ISI and PSS were significant predictors of the GSI in all groups. The PSS exhibited the highest predictive power for 2008 IDPs (β=0.429), while the ISI - in 1993 IDPs (β=0.417). Psychological distress persists over time in IDPs. Although both stress and insomnia are strongly associated with psychological distress, stress has a stronger impact in the early resettlement period, while sleep has a stronger impact later, years after displacement. Therefore, sleep health in displaced population, and on a broader scale in individuals subjected to traumatic events, warrant attention in long-term perspective for implementing targeted interventions and effectively addressing well-being of affected individuals.