Guatemala’s 36-year civil war officially
ended in December 1996 after some 200,000 deaths and one million refugees. Despite
the ceasefire, Guatemala continues to be a violent country with one of the highest
homicide rates in the world. We investigated
potential associations between violence, mental health, and substance abuse in post-conflictGuatemalausing a community-based survey of 86 respondents
living in urban and ruralGuatemala.
Overall, 17.4% of our respondents had at least one, direct violent experience
during the civil war. In the post-conflict period, 90.7% of respondents reported
being afraid that they might be hurt by violence, 40.7% screened positive for depression,
50.0% screened positive for PTSD, and 23.3% screened positive for alcohol dependence.
Potential associations between prior violent experiences during the war and
indicators of PTSD and aspects of alcohol dependence were found in regression-adjusted
models (p < 0.05). Certain associations between prior civil war experiences,
aspects of PTSD and alcohol dependence in this cohort are remarkable, raising concerns
for the health and safety of the largely indigenous populations we studied.
Higher than expected rates of depression, PTSD,
and substance abuse in our cohort may be related to the ongoing violence, injury
and fear that have persisted since the end of the civil war. These, in turn, have
implications for the growing medical and surgical resources needed to address
the continuing traumatic and post-traumatic complications in the post-conflict era.
Limitations of the current study are discussed. These findings are useful in beginning
to understand the downstream effects of the Guatemalan civil war, although a much
larger, randomly sampled survey is now needed.