Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-18T20:11:21.346Z Has data issue: false hasContentIssue false

Trauma and suicidality in war affected communities

Published online by Cambridge University Press:  15 April 2020

J. Jankovic*
Affiliation:
Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK Dudley and Walsall Mental Health Partnership NHS Trust, Dudley, UK
S. Bremner
Affiliation:
Centre for Primary Care and Public Health, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
M. Bogic
Affiliation:
Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
D. Lecic-Tosevski
Affiliation:
Belgrade University School of Medicine, Belgrade, Serbia
D. Ajdukovic
Affiliation:
Faculty of Philosophy, University of Zagreb, Zagreb, Croatia
T. Franciskovic
Affiliation:
School of Medicine, University of Rijeka, Rijeka, Croatia
G.M. Galeazzi
Affiliation:
Department of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
A. Kucukalic
Affiliation:
School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
N. Morina
Affiliation:
Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
M. Popovski
Affiliation:
Faculty of Philosophy, University of Skopje, FYR, Macedonia
M. Schützwohl
Affiliation:
Department of Psychiatry and Psychotherapy, University of Technology, Dresden, Germany
S. Priebe
Affiliation:
Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
*
*Corresponding author. Unit for Social and Community Psychiatry, Queen Mary University of London, Academic Unit, Newham Centre for Mental Health, Cherry Tree Way, Glen Road, London, E13 8SP, United Kingdom. Tel.: +44 02 07 54 04 210; fax: +44 02 07 54 02 976. E-mail address:[email protected] (J. Jankovic).
Get access

Abstract

Purpose

The aim was to assess whether experiences of war trauma remain directly associated with suicidality in war affected communities when other risk factors are considered.

Materials and methods

In the main sample 3313 participants from former Yugoslavia who experienced war trauma were recruited using a random sampling in five Balkan countries. In the second sample 854 refugees from former Yugoslavia recruited through registers and networking in three Western European countries. Sociodemographic and data on trauma exposure, psychiatric diagnoses and level of suicidality were assessed.

Results

In the main sample 113 participants (3.4%) had high suicidality, which was associated with number of potentially traumatic war experiences (odds ratio 1.1) and war related imprisonment (odds ratio 3) once all measured risk factors were considered. These associations were confirmed in the refugee sample with a higher suicidality rate (10.2%).

Discussion and conclusions

Number of potentially traumatic war experiences, in particular imprisonment, may be considered as a relevant risk factor for suicidality in people affected by war.

Keywords

Type
Original article
Copyright
Copyright © 2012 Elsevier Masson SAS

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ajdukovic, DCorkalo, DTrust and betrayal in war. In: Stover, EWeinstein, H.M., editors. My neighbour, my enemy - Justice and community in the aftermath of mass atrocity. Cambridge: Cambridge University Press; 2004. p. 287302.CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed, Washington, DC: American Psychiatric Association; 1994.Google Scholar
Arcel, LSimunkovic-Tocilj, GWar, Violence, Trauma and the Coping Process. Zagreb: Nakladnistvo Limun; 1998.Google Scholar
Basoglu, MLivanou, MCrnobaric, CFranciskovic, TSuljic, EDuric, D, et al.Psychiatric and cognitive effects of war in former Yugoslavia: association of lack of redress for trauma and posttraumatic stress reactions. JAMA 2005; 294: 580590.CrossRefGoogle ScholarPubMed
Breslau, NDavis, GCPeterson, ELSchultz, LPsychiatric sequelae of posttraumatic stress disorder in women. Arch Gen Psychiatry 1997; 54:8187.CrossRefGoogle ScholarPubMed
Bullman, TAKang, HKPosttraumatic stress disorder and the risk of traumatic deaths among Vietnam veterans. J Nerv Ment Dis 1994;82(11):604610.CrossRefGoogle Scholar
Chen, YWDilsaver, SCLifetime rates of suicide attempts among subjects with bipolar and unipolar disorders relative to subjects with other axis I disorders. Biol Psychiatry 1996; 39:896899.CrossRefGoogle ScholarPubMed
Dahl, SMutapcic, ASchei, BTraumatic events and predictive factors for posttraumatic symptoms in displaced Bosnian women in a war zone. J Trauma Stress 1998; 11:137145.CrossRefGoogle Scholar
Davidson, JRTHughes, DCBlazer, DGGeorge, LKPosttraumatic stress disorder in the community: an epidemiological study. Psychol Med 1991;21(3):713721.CrossRefGoogle Scholar
Eurostat. Population Statistics. 2004 ed. Office for Official Publications of the European Communities, 2004.Google Scholar
Floen, SKElklit, APsychiatric diagnoses, trauma, and suicidiality. Ann Gen Psychiatry 2007; 6:12.CrossRefGoogle ScholarPubMed
Fontana, ARosenheck, RAAn etiological model of attempted suicide among Vietnam theatre veterans: prospective generalization to a treatment seeking sample. J Nerv Ment Dis 1995;183(6):377383.CrossRefGoogle Scholar
Fontana, ARosenheck, RAAttempted suicide among Vietnam veterans: a model of etiology in a community sample. Am J Psychiatry 1995;152(1):102109.Google Scholar
Fullerton, CSUrsano, RJEpstein, RSCrowley, BVance, KLKao, TC, et al.Peritraumatic dissociation following motor vehicle accidents: relationship to prior trauma and prior major depression. J Nerv Ment Dis 2000; 188:267272.CrossRefGoogle ScholarPubMed
Kessler, RCBerglund, PBorges, GTrends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. JAMA 2005;293(20):24872495.CrossRefGoogle ScholarPubMed
Kessler, RCGalea, SGruber, MJSampson, NAUrsano, RJWessely, SCTrends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry 2008;13(4):374384.CrossRefGoogle ScholarPubMed
Knox, KLEpidemiology of the relationship between traumatic experience and suicidal behaviors. PTSD Res Q 2008;19(4):17.Google Scholar
Kramer, TLLindy, JDGreen, BLGrace, MCLeonard, ACThe comorbidity of posttraumatic stress disorder and suicidality in Vietnam veterans. Suicide Life Threat Behav 1994;24(1):5867.Google ScholarPubMed
Lecrubier, YSheehan, DVWeiller, EAmorim, PBonora, ISheehan, KH, et al.The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 1997;12(5):224231.CrossRefGoogle Scholar
Lipsicas, CBMakinen, IHApter, ADe Leo, DKerkhof, ALonnqvist, J, et al.Attempted suicide among immigrants in European countries: an international perspective. Soc Psychiatry Psychiatr Epidemiol 2012;47(2):241251.CrossRefGoogle Scholar
Loncar, MMedved, VJovanovic, NHotujac, LPsychological consequences of rape on women in 1991–1995 war in Croatia and Bosnia and Herzegovina. Croat Med J 2006; 47:6775.Google ScholarPubMed
Mufti, KANaeem, FChaudry, HRHaroon, ASaifi, FQureshi, SM, et al.Posttraumatic stress disorder among Afghan refugees following war. Int Psychiatry 2007;4(1):79.CrossRefGoogle Scholar
Nelson, ECHeath, ACMadden, PAFCooper, MLDinwiddie, SHBucholz, KK, et al.Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study. Arch Gen Psychiatry 2002;59(2):139145.CrossRefGoogle ScholarPubMed
Panagioti, MGooding, PTarrier, NPosttraumatic stress disorder and suicidal behavior: a narrative review. Clin Psychol Rev 2009;29(6):471482.CrossRefGoogle ScholarPubMed
Priebe, SBogic, MAjdukovic, DFranciskovic, TGaleazzi, GMKucukalic, A, et al.Mental disorders following war in the Balkans: a study in 5 countries. Arch Gen Psychiatry 2010;67(5):518528.CrossRefGoogle ScholarPubMed
Priebe, SBogic, MAshcroft, RFranciskovic, TGaleazzi, GMKucukalic, A, et al.Experience of human rights violations and subsequent mental disorders- A study following the war in the Balkans. Soc Sci Med 2010;71(12):21702177.CrossRefGoogle ScholarPubMed
Priebe, SGavrilovic Jankovic, JSchuetzwohl, MGaleazzi, GMLecic-Tosevski, DAjdukovic, D, et al.A study of long-term clinical and social outcomes after war experiences in ex-Yugoslavia – Methods of the ‘CONNECT’ project. Psych Today 2004;36(1):101122.Google Scholar
Rossi, AAlberio, RPorta, ASandri, MTansella, MAmaddeo, FThe reliability of the Mini International Neuropsychiatric Interview: Italian version. J Clin Psychopharmacol 2004;24(5):561563.CrossRefGoogle ScholarPubMed
Scholte, WFOlff, MVentevogel, Pde Vries, GJJansveld, ECardozo, BL, et al.Mental health symptoms following war and repression in eastern Afghanistan. JAMA 2004; 292:585593.CrossRefGoogle ScholarPubMed
Sheehan, DVLecrubier, YHarnett-Sheehan, KJanavs, JWeiller, EBonora, LI, et al.Reliability and validity of the Mini International Neuropsychiatric Interview (MINI): according to the SCID-P. Eur Psychiatry 1997;12(5):232241.CrossRefGoogle Scholar
Sheehan, DVLecrubier, YSheehan, KHAmorim, PJanavs, JWeiller, E, et al.Mini International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998; 59(Suppl. 20):2233.Google ScholarPubMed
Southwick, SMMorgan, CANicolaou, ALCharney, DSConsistency of memory for combat-related traumatic events in veterans of operation desert storm. Am J Psychiatry 1997;154(2):173177.Google ScholarPubMed
Spasojevic, JHeffer, RWSnyder, DKEffects of posttraumatic stress and acculturation on marital functioning in Bosnian refugee couples. J Trauma Stress 2000; 13:205217.CrossRefGoogle ScholarPubMed
StataCorp. Stata Statistical Software: Release 10. College Station, TX: StataCorp LP, 2007.Google Scholar
Steel, ZSilove, DMPhan, TBauman, ALong-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: a population-based study. Lancet 2002;360(9399):10561062.CrossRefGoogle ScholarPubMed
Thoresen, SMehlum, LTraumatic stress and suicidal ideation in Norwegian male peacekeepers. J Nerv Ment Dis 2008; 196:814821.CrossRefGoogle ScholarPubMed
Weissman, MMBland, RCCanino, GJGreenwald, SHwu, HGJoyce, PR, et al.Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 1999;29(1):917.CrossRefGoogle ScholarPubMed
Wenzel, TRushiti, FAghani, FDiaconu, GMaxhuni, BZitterl, WSuicidal ideation, posttraumatic stress and suicide statistics in Kosovo. An analysis five years after the war. Suicidal ideation in Kosovo. Torture 2009;19(3):238247.Google ScholarPubMed
Williams, JMGCry of pain. Harmondsworth: Penguin; 1997.Google Scholar
Williams, JMGCrane, CBarnhofer, TDuggan, DPsychology and suicidal behaviour: elaborating the entrapment model. In: Hawton, KPrevention and treatment of suicidal behaviour: from science to practice 2005 OUP Oxford7189.CrossRefGoogle Scholar
Wolfe, JKimerling, RGender issues in the assessment of posttraumatic stress disorder. In: Solomon, S.D.Wilson, JKeane, T.M.Assessing psychological trauma and PTSD New York: Guilford Publications; 1997. p. 192238.Google Scholar
World Health Organisation. Suicide rates per 100,000. 2011. http://www.who.int/mental_health/prevention/suicide_rates/en/index.html.Google Scholar
Zhang, JKai, YFWhat's the relative risk? A method of correcting odds ratio in cohort studies of common outcomes. JAMA 1998; 280:16901691.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.