Revolution's aftermath: population based cross-sectional study to understand the intergeneration mental health and...

Bangladesh was confronted with a nationwide student uprising in July 2024, that exposed both participants and observers to widespread unrest and traumatic events. To better understand the kind of support the population will need, it is important to understand its immediate impact on mental wellbeing.

Aim was to examine the prevalence of trauma symptoms among the Bangladeshi general population, aged 15+, within three-months following revolution.

This cross-sectional survey using the Post Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5, five-point Likert scale), was combined with a one-off online workshop to sensitise this population on mental health, trauma, and resilience. Associations between sociodemographic factors and PCL-5 scores were examined with multiple linear regression (ANOVA/ANCOVA). Probable PTSD (PCL-5 ≥ 31) was assessed using log-binomial regression. We estimated Population Attributable Fractions (PAF), Absolute Risk Reduction (ARR) to estimate the proportion of high PTSD attributable to each exposure, and applied min-max normalisation of Likert scales for cross-item comparison.

More than half of the surveyed participants (n=207; mean age 27.6 ± 9.7 years; 72% Gen Z) had clinically suggestive PTSD. This was more common among women (53.7%), and respondents from Chattogram (57.4%) and Khulna (66.7%). Adjusted analyses suggested modestly higher prevalence among Millennials (PR 1.23, 95% CI 0.87-1.74). PAF estimates indicated small contributions from age groups (Millennials +6.5%, GenX/Boomers -3.6%), and gender (men -3.1%). Under hypothetical elimination of exposure, absolute PTSD reduction was greatest among Millennials. Symptom clusters varied: women, and older adults showed consistently higher scores, while Gen Z reported more negative thoughts/feelings.

The study underscores the potential higher prevalence of probable PTSD following large-scale demonstrations and confrontations, and recommends targeted culturally appropriate mental health interventions. Further research involving a representative sample from the population and longitudinal data is recommended to monitor long-term psychological impacts in Bangladesh.