Characteristics of the Colombian armed conflict and the mental health of civilians living in active conflict zones

An analysis of clinical data from patients (N = 6,353), 16 years and over, from 2010–2011, who consulted in the Colombian departments (equivalent to states) of Nari？o, Cauca, Putumayo and Caquetá. Risk factors were grouped using a hierarchical cluster analysis and the clusters were included with demographic information as predictors in logistic regressions to discern which risk factor clusters best predicted specific symptoms.Three clear risk factor clusters emerged which were interpreted as ‘direct conflict related violence’, ‘personal violence not directly conflict-related’ and ‘general hardship’. The regression analyses indicated that conflict related violence was more highly related to anxiety-related psychopathology than other risk factor groupings while non-conflict violence was more related to aggression and substance abuse, which was more common in males. Depression and suicide risk were represented equally across risk factor clusters.As the largest study of its kind in Colombia it demonstrates a clear impact of the conflict on mental health. Among those who consulted with mental health professionals, specific conflict characteristics could predict symptom profiles. However, some of the highest risk outcomes, like depression, suicide risk and aggression, were more related to factors indirectly related to the conflict. This suggests a need to focus on the systemic affects of armed conflict and not solely on direct exposure to fighting.Although it is now firmly established that armed conflict has a detrimental effect on the mental health of those living in active conflict zones [1-3] it remains the case that we still know remarkably little about how different characteristics of conflict lead to specific forms of psychopathology and psychological impairment in civilians. This is likely due to the fact that great majority of the research on the psychological effects of armed conflict has been conducted on war veterans despite the fact that war leads to a greater