Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-03T00:45:53.913Z Has data issue: false hasContentIssue false
  • English
  • Français

Unconfirmed death as a predictor of psychological morbidity in family members of disappeared persons

Published online by Cambridge University Press:  26 December 2018

Amila Isuru Open the ORCID record for Amila Isuru [Opens in a new window] ,
S. N. Hewage Open the ORCID record for S. N. Hewage [Opens in a new window] ,
Padmakumara Bandumithra  and
S. S. Williams Open the ORCID record for S. S. Williams [Opens in a new window]
Amila Isuru*
Affiliation:
University Psychiatry Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka
S. N. Hewage
Affiliation:
Independent Statistician, Colombo, Sri Lanka
Padmakumara Bandumithra
Affiliation:
District General Hospital, Hambantota, Sri Lanka
S. S. Williams
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
*
Author for correspondence: Amila Isuru, E-mail:[email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The 2004 tsunami, the civil conflict until 2009 and the youth insurrection in the late 1980s in Sri Lanka resulted in many persons being classified as ‘missing’ as they disappeared and were unaccounted for. Our aim was to compare the prevalence of major depressive disorder (MDD) and prolonged grief disorder (PGD) in families of disappeared individuals, who eventually received the mortal remains and those who did not.

Method

An ethically approved cross sectional study was conducted in a purposively selected sample after informed consent. Information on the circumstances of the family member going missing was gathered. Culturally adapted versions of the General Health Questionnaire and the Beck Depression Scale were administered. Those who screened positive were assessed by a psychiatrist on Diagnostic and Statistical Manual of Mental Disorders-5 criteria to arrive at a diagnosis.

Results

Of 391 cases of disappearances studied, MDD (17.5% v. 6%) and PGD (22% v. 7%) were significantly higher in those who did not eventually receive the mortal remains of the disappeared person. Among those who did not receive the mortal remains, being unsure whether the disappeared person was dead or alive was highly predictive of MDD and PGD. Mothers and wives, older family members and those with a family history of mental illness were more vulnerable.

Conclusions

Family members of missing individuals unsure whether their loved one was alive or dead have higher psychological morbidity in the form of MDD and PGD.

Keywords

Ambiguous losscivil conflictdepressiongriefmissing individualsnatural disasterspost-traumatic stress disorderprolonged grief disorderpsychological morbidity
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 16 , December 2019 , pp. 2764 - 2771
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abeysena, C, Jayawardana, P and Peiris, U (2012) Factor structure and reliability of the 30-item Sinhala version of General Health Questionnaire (GHQ). Asian Journal of Psychiatry 5, 150–153.Google Scholar
American Psychiatric Association, DSM-5 Task Force (2013) Diagnostic and Statistical Manual of Mental Disorders: DSM-5™, 5th Edn. Arlington, VA, USA: American Psychiatric Publishing, Inc. http://dx.doi.org/10.1176/appi.books.97808904255962013.Google Scholar
Baraković, D, Avdibegović, E and Sinanović, O (2014) Posttraumatic stress disorder in women with war missing family members. Psychiatria Danubina 26, 340–346.Google Scholar
Basharat, A, Zubair, A and Mujeeb, A (2014) Psychological distress and coping strategies among families of missing persons in Pakistan. Journal of the Indian Academy of Applied Psychology 40, 211.Google Scholar
Beder, J (2002) Mourning the unfound: how we can help. Families in Society: The Journal of Contemporary Social Services 83, 400–403.Google Scholar
Boelen, P (2013) Symptoms of prolonged grief, depression, and adult separation anxiety: distinctiveness and correlates. Psychiatry Research 207, 68–72.Google Scholar
Boelen, P, van de Schoot, R, van den Hout, M, de Keijser, J and van den Bout, J (2010) Prolonged grief disorder, depression, and posttraumatic stress disorder are distinguishable syndromes. Journal of Affective Disorders 125, 374–378.Google Scholar
Boss, P (2002) Ambiguous loss in families of the missing. The Lancet 360, 39–40.Google Scholar
Bryant, RA (2014) Prolonged grief. Current Opinion in Psychiatry 27, 21–26.Google Scholar
Crettol, M and La Rosa, A (2006) The missing and transitional justice: the right to know and the fight against impunity. International Review of the Red Cross 88, 355.Google Scholar
Foa, E, Riggs, D, Dancu, C and Rothbaum, B (1993) Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress 6, 459–473.Google Scholar
Hollifield, M, Hewage, C, Gunawardena, C, Kodituwakku, P, Bopagoda, K and Weerarathnege, K (2008) Symptoms and coping in Sri Lanka 20–21 months after the 2004 tsunami. British Journal of Psychiatry 192, 39–44.Google Scholar
ICRC (2016) Living with uncertainty needs of the families of missing persons in Sri Lanka. ICRC, viewed 11 November 2018. Available at http://www.icrc.org/en/document/sri-lanka-families-missing-persons.Google Scholar
Jackson, C (2007) The General Health Questionnaire (GHQ). Occupational Medicine 57, 79.Google Scholar
Kersting, A, Brähler, E, Glaesmer, H and Wagner, B (2011) Prevalence of complicated grief in a representative population-based sample. Journal of Affective Disorders 131, 339–343.Google Scholar
Nelson, JA, Onwuegbuzie, AJ, Wines, LA and Frels, RK (2013) The therapeutic interview process in qualitative research studies. The Qualitative Report 18, 1–17. Available at http://nsuworks.nova.edu/tqr/vol18/iss40/1.Google Scholar
Powell, S, Butollo, W and Hagl, M (2010) Missing or killed. European Psychologist 15, 185–192.Google Scholar
Prigerson, HG (2004) Complicated grief. Bereavement Care 23, 38–40.Google Scholar
Rodrigo, A, Kuruppuarachchi, K and Pathmeswaran, A (2015) Validation of the Beck depression inventory II among the Sinhalese speaking population in Sri Lanka. Sri Lanka Journal of Psychiatry 6, 20. doi: 10.4038/sljpsyc.v6i2.8076.Google Scholar
Steer, RA, Ball, R, Ranieri, WF and Beck, AT (1999) Dimensions of the Beck depression inventory-II in clinically depressed outpatients. Journal of Clinical Psychology 55, 117–128.Google Scholar
Tsai, W-I, Kuo, S-C, Wen, F-H, Prigerson, HG and Tang, ST (2018) Prolonged grief disorder and depression are distinct for caregivers across their first bereavement year. Psycho-Oncology 27, 1027–1034.Google Scholar
Wijesinghe, C, Williams, S, Kasturiratne, A, Dolawaththa, N, Wimalaratne, P, Wijewickrema, B, Jayamanne, S, Isbister, G, Dawson, A, Lalloo, D and de Silva, H (2015) A randomized controlled trial of a brief intervention for delayed psychological effects in snakebite victims. PLOS Neglected Tropical Diseases 9, e0003989.Google Scholar