The substantial impact of the war in Kosovo has been documented by earlier research performed shortly after the war, but only limited data on the long term mental health impact have been published so far, mostly limited to posttraumatic stress (PTSD). The present study is aimed at extending the focus to a major question so far neglected in most post-conflict zones, namely that of depression and suicidal ideation.
Methods: The present study was based on a representative country-wide survey (n=1161) , using subscales for suicidal behaviour in the General Health Questionnaire (GHQ), comparing results with the corresponding Hopkins Symptom Checklist (HSCL-25) items and the Harvard Trauma Questionnaire (HTQ) to assess war related experiences and PTSD symptomatology. Irrespective of age, gender or education, subjects in rural areas had higher suicide ideation scores, 41.7% of respondents met criteria for moderate to severe depressive symptomatology, 41.6% for clinical anxiety. Unemployment (83.7%), and high PTSD scores were associated with suicidal ideation scores, the last contingent on depressive mood. It is concluded, that suicidal ideation linked to both past stressful experience and present social stressors is a question to be considered in mental health care plans in post-conflict zones. Under-recognition could be expected to result in increasing suicidal behaviour. Ideation also indicates, especially in the context of high post-traumatic stress and depression rates, exhaustion and despair that need to be addressed by more general interventions than individual Psychotherapeutic treatment.