Factors linked to posttraumatic stress disorder in Nagorno-Karabakh refugees residing in Armenia

Abstract Background The military attack against Nagorno-Karabakh (NK) resulted in forced displacement of over 100,000 Armenians in 2023. This study assessed posttraumatic stress disorder (PTSD) and associated factors among refugees aged over 50 from NK settled in Armenia. Methods In 2024, a cross-sectional study surveyed 362 refugees using an interviewer-administered questionnaire, collecting information about socio-demographics, PTSD, anxiety, depression, resilience, health service utilization, social support, health conditions, health behaviors, and health-related quality of life (HRQoL). An ophthalmic examination was performed. Free eyeglasses and medications were provided as needed. Results The participants’ mean age was 64.0±7.94, with equal gender distribution. Visual impairment affected 25.3%, with cataract being the most common eye disease (64%). About 18% of the population reported PTSD, while 24% reported depression symptoms. The mean scores of PTSD, anxiety, and resilience were 19.13 ± 13.76 (out of 80), 3.23 ± 4.30 (out of 21), and 17.54 ±9.21 (out of 40), respectively. The mean HRQoL index score was 0.74 ± 0.21(out of 1.00). Only 5.1% of participants utilized mental health services, while 15.2% utilized general health services. In the adjusted analysis, older age (B = -0.23, CI = -0.36; -0.09), higher household expenditures (B = -7.49, CI = -11.15; -3.84), greater resilience (B = -0.55, CI = -0.68; -0.42) were found to have a protective effect against PTSD. In contrast, higher levels of anxiety (B = 1.59, CI = 1.32; 1.87), and giving emotional support (B = 0.05, CI = 0.01; 0.09) were associated with increased PTSD symptoms. Conclusions Targeted interventions enhancing resilience, reducing financial and emotional burdens, and addressing age- and anxiety-specific needs can mitigate PTSD and improve the well-being of the displaced population. Expanding access to mental health services can help reduce the prevalence of PTSD by ensuring early diagnosis and treatment. Key messages • Older age, higher household expenditures, and greater resilience were found to have a protective effect against PTSD among the displaced population. • Targeted interventions that enhance resilience, reduce financial and emotional burdens, and address age- and anxiety-specific needs can mitigate PTSD of the displaced population.