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The article presents the study conducted by Derrick Silove and colleagues that estimates the preponderance of clinical mental disorders and assess the cultural factors in Timor Leste (East Timor). It discusses the 2-phase total population survey of 1,544 adults in urban and rural area of Timor Leste and cites that the demographic characteristics, posttraumatic stress disorders, and symptoms of psychologic distress were assessed in phase I. In phase 2, on the otherhand, clinicians conducted interviews and assess disability, explanatory models and perceived needs of the subjects. Information on the result and conclusion drawn from the data is also provided.

Abstract: Over several decades, clinicians have documented a pattern of explosive anger amongst survivors of gross human rights violations. Yet there is a dearth of epidemiological research investigating explosive anger in post-conflict countries. In the present study undertaken in Timor-Leste between March and November 2004, we identified an indigenous descriptor for explosive anger, including this index in the East Timor Mental Health Epidemiological Needs Study, a small area total population survey of 1544 adults living in an urban and a rural area. Other measures included indices of past trauma events, post-traumatic stress and general psychological distress, and socio-demographic variables. We found that 38% of the population reached the defined threshold of one attack of explosive anger a month (average=1 episode every 2–3 days). Only a minority of persons with explosive anger reached threshold scores for post-traumatic stress and general psychological distress. High levels of trauma exposure represented the strongest predictor of explosive anger. Latent class analysis identified three sub-groups with explosive anger: young trauma-affected adults living in the capital city who were unemployed; an older group, predominantly men, who had experienced extensive violence, including combat, assault and torture; and a less well characterized group of women. The findings offer support for a sequential model of explosive anger in which experiences of past persecution are compounded by frustrations in the post-conflict environment. The data provide a foundation for exploring further the role of trauma-induced anger in the cycles of violence that are prevalent in post-conflict countries. [Copyright &y& Elsevier]

Background: Studies in developed countries indicate that psychotic-like symptoms are prevalent in the community and are related to trauma exposure and PTSD. No comparable studies have been undertaken in low-income, post-conflict countries. This study aimed to assess the prevalence of psychotic-like symptoms in conflict-affected Timor Leste and to examine whether symptoms were associated with trauma and PTSD., Methods: The Psychosis Screening Questionnaire and the Harvard Trauma Questionnaire (assessing trauma exposure and PTSD) were administered in an epidemiological survey of 1245 adults (response rate 80.6%) in a rural and an urban setting in Timor Leste. We defined PSQ screen-positive cases as those people reporting at least one psychotic-like symptom (paranoia, hallucinations, strange experiences, thought interference, hypomania)., Results: The prevalence of PSQ screen-positive cases was 12 percent and these persons were more disabled. PSQ cases were more likely to reside in the urban area, experienced higher levels of trauma exposure and a greater prevalence of PTSD. PTSD only partially mediated the relationship between trauma exposure and psychotic-like symptoms., Conclusions: Psychotic-like symptoms may be prevalent in countries exposed to mass conflict. The cultural and contextual meaning of psychotic-like symptoms requires further inquiry in low-income, post-conflict settings such as Timor Leste.