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Title: Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys
Authors: Rosellini, A J
Liu, H
Petukhova, M V
Sampson, N A
Aguilar-Gaxiola, S
Alonso, J
Borges, G
Bruffaerts, R
Bromet, E J
de Girolamo, G
de Jonge, P
Fayyad, J
Florescu, S
Gureje, O
Haro, J M
Hinkov, H
Karam, Elie
Kawakami, N
Koenen, K C
Lee, S
Lépine, J P
Levinson, D
Navarro-Mateu, F
Oladeji, B D
O'Neill, S
Pennell, B-E
Piazza, M
Posada-Villa, J
Scott, K M
Stein, D J
Torres, Y
Viana, M C
Zaslavsky, A M
Kessler, R C
Affiliations: Faculty of Medicine 
Keywords: Cross-national
Post-traumatic stress disorder
Issue Date: 2018
Part of: Psychological Medicine
Volume: 48
Issue: 3
Start page: 437
End page: 450
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.
ISSN: 00332917
DOI: 10.1017/S0033291717001817
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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