Journal Article

Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys

Florescu, S., Kessler, R. C., Posada-Villa, J., Piazza, M., Oladeji, B. D., Lee, S., Borges, G., Levinson, D., Liu, H., Petukhova, M. V., Stein, D. J., Alonso, J., O'Neill, S., Viana, M. C., Sampson, N. A., Navarro-Mateu, F., Bromet, E. J., Haro, J. M., Scott, K. M., de Girolamo, G., Karam, E. G., Torres, Y., Fayyad, J., Koenen, K. C., Gureje, O., Aguilar-Gaxiola, S., Hinkov, H., Lépine, J. P., Pennell, B.-E., de Jonge, P., Bruffaerts, R., Rosellini, A. J., Kawakami, N., Zaslavsky, A. M.

2018

Overview

Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors. The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD. 20%, 27%, and 50% of cases recovered within 3, 6, and 24 months and 77% within 10 years (the longest duration allowing stable estimates). Time-related recall bias was found largely for recoveries after 24 months. Recovery was weakly related to most trauma types other than very low [odds-ratio (OR) 0.2-0.3] early-recovery (within 24 months) associated with purposefully injuring/torturing/killing and witnessing atrocities and very low later-recovery (25+ months) associated with being kidnapped. The significant ORs for prior traumas, CAs, and mental disorders were generally inconsistent between early- and later-recovery models. Cross-validated versions of final models nonetheless discriminated significantly between the 50% of respondents with highest and lowest predicted probabilities of both early-recovery (66-55% v. 43%) and later-recovery (75-68% v. 39%). We found PTSD recovery trajectories similar to those in previous studies. The weak associations of pre-trauma factors with recovery, also consistent with previous studies, presumably are due to stronger influences of post-trauma factors.

• Publisher: Cambridge University Press,Cambridge University Press (CUP)
• Subject: Adolescent / Adult / ADULTS / Atrocities / Bias / Child / Child, Preschool / Childhood / Children / Clinical psychology / COMMUNITY / Cross-national / Diagnostic and Statistical Manual of Mental Disorders / Disorders / Epidemiology / Estrès -- Aspectes fisiològics / Female / Health care policy / Health Surveys / Health Surveys - statistics & numerical data / https://purl.org/pe-repo/ocde/ford#5.01.00 / Humans / Infant / Infant, Newborn / Internationality / Interviews / Killing / Life Change Events / Logistic Models / LONG-TERM / Male / Medicine / Mental disorders / Mental health / Middle Aged / Original Articles / Polls & surveys / Post traumatic stress disorder / PREDICTORS / Psychiatry / PTSD / Public health / Rape / Recovery / Recovery of Function / REMISSION / Respondents / Retrospective Studies / RISK / Salut mental / Sex crimes / Stress Disorders, Post-Traumatic / Stress Disorders, Post-Traumatic - rehabilitation / Suicides & suicide attempts / Survival analysis / SYMPTOMS / Time Factors / TRAUMA / Traumatic stress / VERSION / Victimization / Victims of crime / Violence / World Health Organization / Wounds and Injuries / Wounds and Injuries - psychology / Young Adult