Depression and associated factors in forcibly displaced individuals from Nagorno-Karabakh

Objectives

Depression is common among forcibly displaced people due to trauma, loss, and ongoing uncertainty. This study assessed the prevalence of depressive symptoms and associated factors among the displaced population of Nagorno-Karabakh (NK) residing in the Masis community of Ararat province, Armenia.

Methods

As part of the Community Wellbeing Project, launched in Masis to support the overall health, wellbeing, and resilience of the forcibly displaced population of NK, a cross-sectional survey was conducted in 2025 among 746 displaced adults (≥18 years). Data were collected using a structured questionnaire covering sociodemographic characteristics, mental health, overall health status, social support, and service utilization. Generalized estimating equations (GEE) were applied to identify factors associated with depression score, accounting for clustering at the household level.

Results

The mean age of participants was 47.6 ± 16.3. About 61.0% of the population reported depressive symptoms. In the adjusted analysis, higher PTSD score (β = 0.34; 95% CI: 0.30,0.39) and female gender (β = 4.14; 95% CI: 2.99,5.28) were associated with increased depression score and participants who reported “fair or better” self-rated health, compared to those reporting “poor” health, had significantly lower depression scores (β = –1.74; 95% CI: –3.26,–0.21), as did those reporting higher health related quality of life (HRQoL) (β = –3.12; 95% CI: –6.01,–0.22). Participants who were not currently employed had significantly higher depression scores compared to those employed (β = 1.32; 95% CI:–0.03,2.67).

Conclusions

These findings underscore the need for integrated, trauma-informed mental health care, including routine screening for depression, and for addressing social determinants, particularly unemployment, through gender-sensitive, coordinated efforts in displaced populations.

Key messages

• Better self-rated health and higher health-related quality of life were found to have a protective effect against depressive symptoms among the displaced population.

• Routine screening for depression and addressing social determinants, particularly unemployment, may help reduce depressive symptoms in the displaced population.