Research

Evaluation of psychological support for victims of sexual violence in a conflict setting: results from Brazzaville, Congo

Sarah Hustache¹ , Marie-Rose Moro^2,3,4 , Jacky Roptin⁴ , Renato Souza⁵ , Grégoire Magloire Gansou⁶ , Alain Mbemba⁷ , Thomas Roederer¹ , Rebecca F Grais¹ , Valérie Gaboulaud^1,2 and Thierry Baubet^1,4

¹  Epicentre, 8 rue Saint Sabin, 75011, Paris, France

²  Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Université de Paris 13, 125 rue de Stalingrad, 93009 Bobigny, France

³  Hôpital Cochin, Maison des adolescents, Université de Paris 5, 97 Bd de Port Royal, 75679, Paris cedex 14, France

⁴  Médecins Sans Frontières France, 8 rue Saint Sabin, Paris, France

⁵  Médecin Sans Frontières Switzerland, 78 Rue de Lausanne, CP 116, 1211, Geneva 21, Switzerland

⁶  Faculté des Sciences de la Santé, Abomey-Calavi University, Centre National Hospitalier et Universitaire Hubert Koutoukou Maga, 03 BP 1890, Cotonou, Benin

⁷  Makélékélé Hospital, Brazzaville, Hôpital de base de Makélékélé, BP 3219, Bacongo, Republic of Congo

author email corresponding author email

International Journal of Mental Health Systems 2009, 3:7doi:10.1186/1752-4458-3-7

Published:	1 April 2009

Abstract

Background

Little is known about the impact of psychological support in war and transcultural contexts and in particular, whether there are lasting benefits. Here, we present an evaluation of the late effect of post-rape psychological support provided to women in Brazzaville, Republic of Congo.

Methods

Women who attended the Médecins Sans Frontières program for sexual violence in Brazzaville during the conflict were selected to evaluate the psychological consequences of rape and the late effect of post-rape psychological support. A total of 178 patients met the eligibility criteria: 1) Women aged more than 15 years; 2) raped by unknown person(s) wearing military clothes; 3) admitted to the program between the 1/1/2002 and the 30/4/2003; and 4) living in Brazzaville.

Results

The initial diagnosis according to DSM criteria showed a predominance of anxious disorders (54.1%) and acute stress disorders (24.6%). One to two years after the initial psychological care, 64 women were evaluated using the Trauma Screening Questionnaire (TSQ), the Global Assessment of Functioning scale (GAF) and an assessment scale to address medico-psychological care in emergencies (EUMP). Two patients (3.1%) met the needed criteria for PTSD diagnosis from the TSQ. Among the 56 women evaluated using GAF both as pre and post-test, global functioning was significantly improved by initial post-rape support (50 women (89.3%) had extreme or medium impairment at first post-rape evaluation, and 16 (28.6%) after psychological care; p = 0.04). When interviewed one to two years later, the benefit was fully maintained (16 women (28.6%) presenting extreme or medium impairment).

Conclusion

We found the benefits of post-rape psychological support to be present and lasting in this conflict situation. However, we were unable to evaluate all women for the long-term impact, underscoring the difficulty of leading evaluation studies in unstable contexts. Future research is needed to validate these findings in other settings.