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

Published online by Cambridge University Press:  29 November 2012

S. Priebe ,
J. Gavrilovic ,
S. Bremner ,
D. Ajdukovic ,
T. Franciskovic ,
G. Neri ,
A. Kucukalic ,
D. Lecic-Tosevski ,
N. Morina  and
M. Popovski
...Show all authors
S. Priebe*
Affiliation:
Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
J. Gavrilovic
Affiliation:
Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
S. Bremner
Affiliation:
Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
D. Ajdukovic
Affiliation:
Faculty of Philosophy, University of Zagreb, Croatia
T. Franciskovic
Affiliation:
School of Medicine, University of Rijeka, Croatia
G. Neri
Affiliation:
Department of Psychiatry, University of Modena and Reggio Emilia, Italy
A. Kucukalic
Affiliation:
School of Medicine, University of Sarajevo, Bosnia and Herzegovina
D. Lecic-Tosevski
Affiliation:
Belgrade University School of Medicine, Belgrade, Serbia
N. Morina
Affiliation:
Department of Clinical Psychology, University of Amsterdam, The Netherlands
M. Popovski
Affiliation:
Faculty of Philosophy, University of Skopje, FYRMacedonia
M. Schützwohl
Affiliation:
Department of Psychiatry and Psychotherapy, University of Technology, Dresden, Germany
M. Bogic
Affiliation:
Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
A. Matanov
Affiliation:
Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
*
*Address for correspondence: Professor S. Priebe, Unit for Social and Community Psychiatry, Newham Centre for Mental Health, London E13 8SP, UK. (Email: [email protected])
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Abstract

Background

Prevalence 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.

Method

We 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.

Results

During 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.

Conclusions

Several 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.

Keywords

PTSDPTSD symptom changewar traumarefugeespost-conflict regions
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 9 , September 2013 , pp. 1837 - 1847
Copyright
Copyright © Cambridge University Press 2012 

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