Original scientific paper
Consequences of Untreated Posttraumatic Stress Disorder Following War in Former Yugoslavia: Morbidity, Subjective Quality of Life, and Care Costs
Stefan Priebe
; The Unit for Social&Community Psychiatry, Queen Mary University of London, London, UK
Aleksandra Matanov
; The Unit for Social&Community Psychiatry, Queen Mary University of London, London, UK
Jelena Janković Gavrilović
; The Unit for Social&Community Psychiatry, Queen Mary University of London, London, UK
Paul McCrone
; Centre for Economics of Mental Health, Health Services Research Department, Institute of Psychiatry, London, UK
Damir Ljubotina
; Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
Goran Knežević
; International Aid Network, Belgrade, Serbia
Abdulah Kučukalić
; Department of Psychiatry, University Medical Centre, Sarajevo, Bosnia and Herzegovina
Tanja Frančišković
; Centre for Psychiatric Clinic, University of Rijeka, Croatia
Matthias Schützwoh
; Department of Psychiatry and Psychotherapy, Dresden Technical University, Dresden, Germany
Abstract
Aim To assess long-term mental health outcomes in people
who suffer from war-related posttraumatic stress disorder
(PTSD) but do not receive appropriate treatment.
Methods We interviewed 264 subjects from former Yugoslavia,
who lived in Croatia, Serbia, Germany, and the United
Kingdom. All of them had suffered from PTSD at some
point following the war, but never received psychiatric or
psychological treatment. The interviews took place on average
10.7 ± 3.0 years after the war-related trauma. Outcomes
were current PTSD on the Clinician Administered
PTSD Scale for Diagnostic and Statistical Manual of Mental
Disorders-IV, subjective quality of life (SQOL) on the Manchester
Short Assessment of Quality of Life, and care costs.
Socio-demographic characteristics, the level of traumatic
war-events, and aspects of the post-war situation were
tested for association with outcomes.
Results Current PTSD was diagnosed in 83.7% of participants,
the mean SQOL score was 4.0 ± 0.9, and mean care
costs in the last 3 months exceeded €1100 in each center.
Older age, more traumatic war-events, lower education,
and living in post-conflict countries were associated
with higher rates of current PTSD. Older age, combat experience,
more traumatic war-events, being unemployed,
living alone, being housed in collective accommodation,
and current PTSD were independently associated with
lower SQOL. Older age and living in Germany were linked
to higher costs of formal care.
Conclusion People with untreated war-related PTSD have
a high risk of still having PTSD a decade after the traumatic
event. Their SQOL is relatively low, and they generate considerable
care costs. Factors that have been reported as influencing
the occurrence of PTSD also appear relevant for
recovery from PTSD. Current PTSD may impair SQOL independently
of social factors.
Keywords
Post-traumatic stress disorder; subjective quality of life; war trauma; refugees; care costs; mental health outcomes
Hrčak ID:
47868
URI
Publication date:
15.10.2009.
Visits: 3.913 *