Caseness and comorbidity of probable (complex) post-traumatic stress disorder and depression in survivors of genocide against Tutsi in Rwanda: the role of social determinants

Abstract

Numerous studies have been conducted among survivors of the genocide against the Tutsi on the prevalence of depression and post-traumatic stress disorder. However, thus far, no studies provide information on the frequency of comorbidity of these disorders, the prevalence of the new trauma-related diagnostic disorder known as complex post-traumatic stress disorder, and the role of social determinants, such as age, sex, marital status, employment category, education, and location, in the occurrence of these disorders. The present study was conducted to address these gaps. Genocide survivors ( N = 261 participants; M = 46.30, SD = 11.95, females = 52.9%) took part in the study. They completed the International Trauma Questionnaire, the Public Health Depression Questionnaire, and the Harvard Trauma Questionnaire. Descriptive statistical analyses, bivariate analyses with two-tailed chi-square tests, and logistic regression were used to determine the prevalence of the above-mentioned disorders, comorbidity, and the associations between the social determinants and the assessed psychopathologies. Of the total sample, 47.1% presented with at least one of the assessed probable mental health disorders: 15.3% ( n = 40) met the criteria for probable post-traumatic stress disorder, 15.3% ( n = 40) for probable complex post-traumatic stress disorder, and 38.7% ( n = 101) for probable depression. Of the participants with probable post-traumatic stress disorder and complex post-traumatic stress disorder, nearly half met the criteria for probable depression. Being married but not living with the partner was associated with probable complex post-traumatic stress disorder, and unemployment was associated with probable depression. Our findings suggest to clinicians and policymakers that they should consider comorbidity and social determinants in their interventions.