Mental health and nutritional status among the adult Serbian minority in Kosovo

Context Since the beginning of the North Atlantic Treaty Organization inter vention in Kosovo in June 1999, few objective data have been available on r elevant health indicators for the Serbian ethnic minority in Kosovo. Objective To determine the prevalence of undernutrition among Serbian adult s aged 60 years or older and psychiatric morbidity among the adult Serbian population in Kosovo. Design, Setting, and Participants A systematic random sample survey of 212 households was conducted between September 27 and October 2, 1999, in Prist ina, the capital city, and in 10 towns in the rural municipality of Gnjilan e in Kosovo. Of the 212 households surveyed, 204 adults aged 15 years or ol der completed the General Health Questionnaire-28 (GHQ-28) and anthropometr ic measurements were taken for 98 adults aged 60 years or older and for a c omparison group of 51 adults aged 18 to 59 years. Main Outcome Measures Body mass index of less than 18.5 kg/m(2) in older ad ults; nonspecific psychiatric morbidity among adults; and self-reported use of health care services, access to food rations, and primary sources of pr ewar and postwar income. Results Undernutrition was found in 11.2% (95% confidence interval [CI], 5. 7%-19.2%) of Serbian adults aged 60 years or older compared with 2.0% (95% CI, 0.1% 11.8%) of Serbian adults aged 18 to 59 years. The mean (SE) total score for the GHQ-28 was 13.0 (0.52). In a comparison of the GHQ-28 scores of the Serbian adults with the Kosovar Albanian adults (data from a recent survey), the mean (SE) score adjusted for age and sex was 12.8 (0.52) vs 11 .1 (0.58); P=.03, respectively. The GHQ-28 scores were also higher for the Serbians in the subcategories of social dysfunction (2.8 [0.17] vs 2.2 [0.1 3], P=.008) and severe depression (1.9 [0.15] vs 0.9 [0.09]; P<.001), respe ctively. Serbian women and persons living alone or in small family units we re more prone to psychiatric morbidity. Of the 141 respondents reporting th e need for health care services, 83 (57.6%) reported not obtaining such ser vices; 204 of 212 (96.2%) households were on a food distribution list. The majority of prewar income came from government jobs compared with farming a nd humanitarian aid for postwar income. Conclusions The undernutrition of older Serbian adults in Kosovo should be monitored. The high prevalence of symptoms of social dysfunction and severe depression suggest the need for implementation of mental health programs i n the Serbian community.