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Dealing with long-term deliberating health conditions after trauma remains a challenge in the post-conflict setting. The first, we conducted a district-level cross-sectional cluster survey of 1,115 households with a population of 6,845 in Mitrovice district in Northern Kosovo. The second, 63 male and 62 female victims of torture and massive violence identified in the household survey were recruited for a detailed study. Patient Health Questionnaire-Brief, the McGill Pain Questionnaire and the Margolis Pain Diagram were used for the detailed assessment.
Over 90% of 1,115 families had been exposed to at least two categories of violence and human rights violations in Mitrovice district, and 493 individuals from 341 families reported torture experiences. During the two weeks before the survey, 20% of sample population of 6,845 reported physical or mental pain. If the families exposed to more categories of violence and human rights violations, higher proportion of household members reported lifetime experience of violence-attributable injury and pain complaints. Among 125 victims who were recruited for a detailed assessment, 90% were doing unpaid work and 50% took medications against depression and anxiety. There was substantial overlap between chronic pain and mental problems. Victims with mental problems or reported bodily injury showed significantly higher pain score. Anger, hatred and an inferiority complex particularly amplified their pain experience. Non-specific headache was constant and prevalent in those with mental problems and, more markedly, with recent experience of anger, aggressiveness and hatred. Risk of changing job or stopping job or schooling due to depression or injury increased significantly for those with higher sensory dimensional pain score and with pain in neck, shoulder or upper limbs.
Conclusion:
The results of both assessments show the effects of violence are not confined to individuals. Emotional disturbance can be contagious and may inflict enduring pain and suffering among family members.
Learning Objectives: 1. We defined the association between prevalence of lifetime experience on violence-attributable injury and pain complaints and the level of collective exposure to violence at household level. 2. We analyzed the difference in pain characteristics in 125 victims with PTSD, major depression and anxiety disorder, emotional disturbance. 3. We analyzed the interactive effect of anger, hatred, chronic pain and multiple comorbid conditions on the employment outcomes in 125 victims.