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Title: Trauma and PTSD in the WHO World Mental Health Surveys
Authors: Kessler, Ronald C
Aguilar-Gaxiola, Sergio
Alonso, Jordi
Benjet, Corina
Bromet, Evelyn J
Cardoso, Graça
Degenhardt, Louisa
de Girolamo, Giovanni
Dinolova, Rumyana V
Ferry, Finola
Florescu, Silvia
Gureje, Oye
Haro, Josep Maria
Huang, Yueqin
Karam, Elie G
Kawakami, Norito
Lee, Sing
Lepine, Jean-Pierre
Levinson, Daphna
Navarro-Mateu, Fernando
Pennell, Beth-Ellen
Piazza, Marina
Posada-Villa, José
Scott, Kate M
Stein, Dan J
Ten Have, Margreet
Torres, Yolanda
Viana, Maria Carmen
Petukhova, Maria V
Sampson, Nancy A
Zaslavsky, Alan M
Koenen, Karestan C
Affiliations: Faculty of Medicine 
Keywords: Burden of illness
Disorder prevalence and persistence
Post-traumatic stress disorder (PTSD)
Trauma exposure
Issue Date: 2017
Publisher: National Library of Medicine
Part of: European Journal of Psychotraumatology
Volume: 8
Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their 'worst.' Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method: WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the 'worst' lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results: In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions: Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits within months after onset, mean symptom duration is considerably longer than previously recognized.
ISSN: 2000-8066
DOI: 10.1080/20008198.2017.1353383
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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