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

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Rosellini, A. J. ^[1] ; Liu, H. ^{[2, 3]} ; Petukhova, M. V. ^[2] ; Sampson, N. A. ^[2] ; Aguilar-Gaxiola, S. ^[4] ; Alonso, J. ^{[5, 6]} ; Borges, G. ^[7] ; Bruffaerts, R. ^[8] ; Bromet, E. J. ^[9] ; de Girolamo, G. ^[10] ; de Jonge, P. ^{[11, 12]} ; Fayyad, J. ^[13] ; Florescu, S. ^[14] ; Gureje, O. ^[15] ; Haro, J. M. ^[16] ; Hinkov, H. ^[17] ; Karam, E. G. ^{[13, 18]} ; Kawakami, N. ^[19] ; Koenen, K. C. ^[3] ; Lee, S. ^[20] ; Lepine, J. P. ^[21] ; Levinson, D. ^[22] ; Navarro-Mateu, F. ^[23] ; Oladeji, B. D. ^[15] ; O'Neill, S. ^[24] ; Pennell, B. E. ^[25] ; Piazza, M. ^[26] ; Posada-Villa, J. ^[27] ; Scott, K. M. ^[28] ; Stein, D. J. ^[29] ; Torres, Y. ^[30] ; Viana, M. C. ^[31] ; Zaslavsky, A. M. ^[2] ; Kessler, R. C. ^[2] ; Survey, WHO World Mental Hlth

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^[1] Boston Univ, Dept Psychol & Brain Sci, Boston, MA - USA

^[2] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA - USA

^[3] Harvard T H Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA - USA

^[4] UC Davis Hlth Syst, Ctr Reducing Hlth Dispar, Sacramento, CA - USA

^[5] CIBERESP, Barcelona - Spain

^[6] Pompeu Fabra Univ UPF, IMIM Hosp Mar Res Inst, Parc Salut Mar, Barcelona - Spain

^[7] Natl Inst Psychiat Ramon Fuente, Mexico City, DF - Mexico

^[8] UPC KUL, Campus Gasthuisberg, Leuven - Belgium

^[9] Stony Brook Univ Sch Med, Dept Psychiat, Stony Brook, NY - USA

^[10] IRCCS St John God Clin Res Ctr IRCCS Centro S Gio, Brescia - Italy

^[11] Univ Groningen, Dept Psychol, Dev Psychol, Groningen - Netherlands

^[12] Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Interdisciplinary Ctr Psychopathol & Emot Regulat, Groningen - Netherlands

^[13] Inst Dev, Res, Advocacy Appl Care IDRAAC, Beirut - Lebanon

^[14] Natl Sch Publ Hlth, Management & Dev, Bucharest - Romania

^[15] Univ Ibadan, Dept Psychiat, Coll Med, Ibadan - Nigeria

^[16] Univ Barcelona, Parc Sanitari Sant Joan Deu, CIBERSAM, Barcelona - Spain

^[17] Natl Ctr Publ Hlth & Analyses, Sofia - Bulgaria

^[18] Balamand Univ, St George Hosp Univ Med Ctr, Dept Psychiat & Clin Psychol, Fac Med, Beirut - Lebanon

^[19] Univ Tokyo, Sch Publ Hlth, Dept Mental Hlth, Tokyo - Japan

^[20] Chinese Univ Hong Kong, Dept Psychiat, Tai Po, Hong Kong - Peoples R China

^[21] Univ Paris Descartes Paris Diderot, Hop Lariboisiere Fernand Widal, Assistance Publ Hopitaux Paris, INSERM UMR S 1144, Paris - France

^[22] Mental Hlth Serv, Minist Hlth, Jerusalem - Israel

^[23] Servicio Murciano Salud, UDIF SM, Subdirecc Gen Planificac, Innovac Cronicidad, Murcia - Spain

^[24] Ulster Univ, Sch Psychol, Londonderry - North Ireland

^[25] Univ Michigan, Inst Social Res, Survey Res Ctr, Ann Arbor, MI - USA

^[26] Univ Cayetano Heredia, Natl Inst Hlth, Lima - Peru

^[27] Colegio Mayor Cundinamarca Univ, Bogota - Colombia

^[28] Univ Otago, Dept Psychol Med, Dunedin - New Zealand

^[29] Univ Cape Town, Dept Psychiat & Mental Hlth, Cape Town - South Africa

^[30] CES Univ, Ctr Excellence Res Mental Hlth, Medellin - Colombia

^[31] Univ Fed Espirito Santo, Dept Social Med, Vitoria - Brazil

• Tipo de documento: Artigo Científico
• Fonte: PSYCHOLOGICAL MEDICINE; v. 48, n. 3, p. 437-450, FEB 2018.
• Citações Web of Science: 5

Resumo

Background 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. Methods 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. Results 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%). Conclusions 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. (AU)

• Processo FAPESP: 03/00204-3 - Estudo epidemiológico dos transtornos psiquiátricos na região metropolitana de São Paulo: prevalências, fatores de risco e sobrecarga social e econômica
• Beneficiário: Laura Helena Silveira Guerra de Andrade
• Modalidade de apoio: Auxílio à Pesquisa - Temático