Course of post-traumatic stress disorder following war in the Balkans: 1-year follow-up study

2012 ◽  
Vol 43 (9) ◽  
pp. 1837-1847 ◽  
Author(s):  
S. Priebe ◽  
J. Gavrilovic ◽  
S. Bremner ◽  
D. Ajdukovic ◽  
T. Franciskovic ◽  
...  

BackgroundPrevalence rates of post-traumatic stress disorder (PTSD) following the experience of war have been shown to be high. However, little is known about the course of the disorder in people who remained in the area of conflict and in refugees.MethodWe studied a representative sample of 522 adults with war-related PTSD in five Balkan countries and 215 compatriot refugees in three Western European countries. They were assessed on average 8 years after the war and reinterviewed 1 year later. We established change in PTSD symptoms, measured on the Impact of Events Scale – Revised (IES-R), and factors associated with more or less favourable outcomes.ResultsDuring the 1-year period, symptoms decreased substantially in both Balkan residents and in refugees. The differences were significant for IES-R total scores and for the three subscales of intrusions, avoidance and hyperarousal. In multivariable regressions adjusting for the level of baseline symptoms, co-morbidity with depression predicted less favourable symptom change in Balkan residents. More pre-war traumatic events and the use of mental health services within the follow-up period were associated with less improvement in refugees.ConclusionsSeveral years after the war, people with PTSD reported significant symptom improvement that might indicate a fluctuating course over time. Co-morbid depression may have to be targeted in the treatment of people who remained in the post-conflict regions whereas the use of mental health services seems to be linked to the persistence of symptoms among refugees.

2018 ◽  
Vol 212 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Stan Zammit ◽  
Catrin Lewis ◽  
Sarah Dawson ◽  
Hannah Colley ◽  
Hannah McCann ◽  
...  

BackgroundComorbid post-traumatic stress disorder (PTSD) is associated with poorer outcomes of other disorders, but is treatable.AimsTo estimate the frequency of clinically undetected PTSD in secondary care.MethodA systematic review of studies that screened for PTSD and reported on PTSD documentation in clinical records. Frequency of undetected PTSD was estimated, and reasons for heterogeneity explored.ResultsThe median proportion of participants with undetected PTSD (29 studies) was 28.6% (interquartile range 18.2–38.6%). There was substantial heterogeneity, with studies conducted in the USA and those with the highest proportions of in-patients and patients with psychotic disorder reporting higher frequencies of undetected PTSD.ConclusionsUndetected PTSD is common in secondary care, even if the true value is at the lower limit of the estimates reported here. Trials examining the impact of routine screening for PTSD are required to determine whether such programmes should be standard procedure for all mental health services.Declaration of interestNone.


2021 ◽  
pp. 000486742098141
Author(s):  
Jessica C Bird ◽  
Emma C Fergusson ◽  
Miriam Kirkham ◽  
Christina Shearn ◽  
Ashley-Louise Teale ◽  
...  

Objective: Paranoia may be particularly prevalent during adolescence, building on the heightened social vulnerabilities at this age. Excessive mistrust may be corrosive for adolescent social relationships, especially in the context of mental health disorders. We set out to examine the prevalence, symptom associations, and persistence of paranoia in a cohort of young people attending child and adolescent mental health services. Method: A total of 301 patients (11–17 years old) completed measures of paranoia, affect, peer difficulties and behavioural problems. Clinicians also rated each participant’s psychiatric symptoms. Patterns of association were examined using linear regressions and network analyses. In total, 105 patients repeated the measures several months later. Results: Most of the adolescents had affective disorders ( n = 195), self-harm/suicidality ( n = 82), or neurodevelopmental conditions ( n = 125). Few had suspected psychosis ( n = 7). Rates of paranoia were approximately double compared with previous reports from the general population. In this patient sample, 35% had at least elevated paranoia, 15% had at least moderate paranoia, and 6% had high paranoia. Paranoia had moderate associations with clinician-rated peer difficulties, self-harm, and trauma, and small associations with clinician-rated social anxiety, depression, generalised anxiety, and educational problems. Network analyses showed paranoia had the strongest unique relationship with peer difficulties. Paths from peer difficulties to anxiety, self-harm, post-traumatic stress disorder symptoms, and behavioural problems were all via paranoia. Both self-harm and post-traumatic stress disorder were solely associated with paranoia in the network. Paranoia remained persistent for three-quarters and was associated with greater psychological problems over time. Conclusion: Paranoia is relatively common and persistent across a range of clinical presentations in youth. When paranoia occurs alongside emotional problems, important peer interactions may be adversely affected. Wider consideration of paranoia in adolescent patients is needed.


2020 ◽  
pp. bmjmilitary-2020-001622 ◽  
Author(s):  
Dominic Murphy ◽  
C Williamson ◽  
J Baumann ◽  
W Busuttil ◽  
N T Fear

IntroductionData are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic.MethodsData were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions—Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity.ResultsIt was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties.ConclusionsOur findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.


2021 ◽  
Vol 10 (34) ◽  
pp. 2884-2887
Author(s):  
Ajay Kumar Joopaka ◽  
Molanguri Umashankar ◽  
Pingali Srilakshmi ◽  
Pradeep Sharma Telkapalli ◽  
Chinni Krishna Banoth ◽  
...  

BACKGROUND Corona virus disease or the (COVID 19) has caused mental health problems in the general population, in people infected and hospitalised for the disease and in patients who have recovered from the disease physically but continue to suffer from lingering mental health problems. Studies have shown stress, depression, and anxiety in one third of the survivors. Similarly post-traumatic stress disorder has been reported to be around 13 % in the survivors of COVID 19. In this study, we wanted to assess the psychological symptoms in the survivors of Covid 19 patients, one month post discharge and also assess various factors associated with the same. METHODS A cross sectional telephonic survey of the patients one month following discharge was done to understand the psychological problems. Sociodemographic data was recorded on a semi structured proforma, whereas psychological distress was recorded on patient health questionnaire - 4 (PHQ - 4) and the post-traumatic stress disorder (PTSD) was screened for by the impact of event scale revised (IES - R). RESULTS Of the 200 patients evaluated, 46.8 % scored above 20 on the impact of event scale which was considered to be a positive screen for post-traumatic stress disorder. Moderate psychological distress was reported by 10.5 % and severe by 7.5 % as measured by PHQ - 4. Being married, having other family members effected by the infection and deaths in the family were some of the factors that were significantly associated with psychological distress and symptoms of post-traumatic stress disorder. CONCLUSIONS Continued mental health support needs to be extended to members who are considered to have recovered and discharged from the hospital following the COVID 19 infection. KEY WORDS COVID 19, Psychological Symptoms, Post-Traumatic Stress Disorder


2020 ◽  
Vol 2 (3) ◽  
pp. 65-85
Author(s):  
Kristia Novia ◽  
Tita Hariyanti ◽  
Laily Yuliatun

Natural disasters are still a matter of the world until today. The events pose not only physical impact but also psychological impacts that leave deep sorrow and fear. The survivors of the disaster felt they were at a very unsettled condition, felt very fearful, felt agitated for uncertain circumstances, and became very easily panicked until they could experience anxiety, depression, and post-traumatic stress disorder (PTSD). This systematic review aims to identify the impact–effects often posed by natural disasters on the soul health of survivors. Data searching is done on the Proquest, Pubmed, Science Direct, Sage, and Scopus databases that were converged in the 2013 to 2019 ranges. The psychological impact experienced by the victims after natural disaster events are depression, post-traumatic stress disorder (PTSD), fear, suicide experiments, and other mental health disorders such as mood changes and a loss of interest in an activity. Natural disasters can hurt the mental health of the victims. If the psychological problems that occur to the victims are not immediately addressed, the victims will fall on more mental severe disorder conditions.


Author(s):  
Carmen M. Martínez-Caballero ◽  
Rosa M. Cárdaba-García ◽  
Rocío Varas-Manovel ◽  
Laura M. García-Sanz ◽  
Jorge Martínez-Piedra ◽  
...  

The early stages of the COVID-19 pandemic presented the characteristics of a traumatic event that could trigger post-traumatic stress disorder. Emergency Medical Services workers are already a high-risk group due to their professional development. The research project aimed to analyse the impact of the COVID-19 pandemic on EMS professionals in terms of their mental health. For this purpose, we present a descriptive crosssectional study with survey methodology. A total of 317 EMS workers (doctors, nurses, and emergency medical technicians) were recruited voluntarily. Psychological distress, post-traumatic stress disorder, and insomnia were assessed. The instruments were the General Health Questionnaire-12 (GHQ-12), the Davidson Trauma Scale (DTS-8), and the Athens Insomnia Scale (AIS-8). We found that 36% of respondents had psychological distress, 30.9% potentially had PTSD, and 60.9% experienced insomnia. Years of work experience were found to be positively correlated, albeit with low effect, with the PTSD score (r = 0.133). Finally, it can be stated that the COVID-19 pandemic has been a traumatic event for EMS workers. The number of professionals presenting psychological distress, possible PTSD, or insomnia increased dramatically during the early phases of the pandemic. This study highlights the need for mental health disorder prevention programmes for EMS workers in the face of a pandemic.


2018 ◽  
Vol 3 (1) ◽  
pp. 45-55
Author(s):  
Durga Mishra ◽  
Deena Giri ◽  
Sujan Babu Marahatta

Background: On April 25, 2015 at 11:56 local time, a great earthquake of massive magnitude-7.8 trembler was experienced in Nepal. Along with the physical and economical loss, such disasters can have devastating consequences in adolescent’s mental health. The purpose of this study is to determine the prevalence of Post-Traumatic Stress Disorder and associated factors among adolescents after 2015 Nepal Earthquake.Methods: A total of 140 adolescents from grade 8, 9 and 10 of two higher secondary schools were recruited in this study. Post-Traumatic Stress Disorder CheckList-5 (PCL-5) of DSM-V criteria was used for the diagnosis of Post-Traumatic Stress Disorder. Chi-square test was used to assess the association.Results: Among 140 adolescents, the age range was 12 to 19 years with a mean age of 14.8 (SD=1.1) where 27.1% of the participants had Post-Traumatic Stress Disorder.  A statistically significant association was found between Post-Traumatic Stress Disorder and grade (χ² = 9.324, p<0.01), earthquake exposure (χ² =32.251, p<0.001) and death of someone close in earthquake (χ² = 9.535, p<0.01). Majority of the respondents reported symptoms of avoiding memories, thoughts, or feelings related to the stressful experience (58.57%).Conclusions: This study hopes to assist the therapist, psychiatrists and planners in the design and implementation of effective and appropriate intervention programs that can help reduce the impact of Post-Traumatic Stress Disorder on adolescents, aid in psychological reconstruction and decrease the long term negative mental health consequences of such disasters especially for those who are at lower grade, were exposed to earthquake and lost their close people in the earthquake.Journal of Manmohan Memorial Institute of Health SciencesVol. 3, No. 1, 2017, page: 45-55


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