Posttraumatic stress disorder in the World Mental Health Surveys.
Por:
Koenen KC, Ratanatharathorn A, Ng L, McLaughlin KA, Bromet EJ, Stein DJ, Karam EG, Meron Ruscio A, Benjet C, Scott K, Atwoli L, Petukhova M, Lim CC, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Bunting B, Ciutan M, de Girolamo G, Degenhardt L, Gureje O, Haro JM, Huang Y, Kawakami N, Lee S, Navarro-Mateu F, Pennell BE, Piazza M, Sampson N, Ten Have M, Torres Y, C Viana M, Williams D, Xavier M and Kessler RC
Publicada:
1 oct 2017
Ahead of Print:
7 abr 2017
Resumen:
BACKGROUND: Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking. METHODS: Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics. RESULTS: The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed. CONCLUSIONS: PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.
Filiaciones:
Koenen KC:
Department of Epidemiology,Harvard T.H. Chan School of Public Health,Boston, Massachusetts,USA
Ratanatharathorn A:
Department of Epidemiology,Mailman School of Public Health,Columbia University,New York,USA
Ng L:
Department of Psychiatry,Boston University School of Medicine and Boston Medical Center,Boston, Massachusetts,USA
McLaughlin KA:
Department of Psychology,University of Washington,Seattle, Washington,USA
Bromet EJ:
Department of Psychiatry,Stony Brook University School of Medicine,Stony Brook, New York,USA
Stein DJ:
Department of Psychiatry and Mental Health,University of Cape Town,Cape Town,Republic of South Africa
Karam EG:
Department of Psychiatry and Clinical Psychology, Faculty of Medicine,Balamand University,Beirut,Lebanon
Meron Ruscio A:
Department of Psychology,University of Pennsylvania,Philadelphia, Pennsylvania,USA
Benjet C:
Department of Epidemiologic and Psychosocial Research,National Institute of Psychiatry Ramón de la Fuente,Mexico City,Mexico
Scott K:
Department of Psychological Medicine,University of Otago,Dunedin, Otago,New Zealand
Atwoli L:
Department of Mental Health,Moi University School of Medicine,Eldoret,Kenya
Petukhova M:
Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA
Lim CC:
Department of Psychological Medicine,University of Otago,Dunedin, Otago,New Zealand
Aguilar-Gaxiola S:
Center for Reducing Health Disparities,UC Davis Health System,Sacramento, California,USA
Al-Hamzawi A:
College of Medicine,Al-Qadisiya University,Diwania governorate,Iraq
Alonso J:
Health Services Research Unit,IMIM-Hospital del Mar Medical Research Institute,Pompeu Fabra University (UPF)
CIBER en Epidemiología y Salud Pública (CIBERESP),Barcelona,Spain
Bunting B:
School of Psychology, Ulster University,Londonderry,UK
Ciutan M:
National School of Public Health, Management and Professional Development,Bucharest,Romania
de Girolamo G:
IRCCS St John of God Clinical Research Centre // IRCCS Centro S. Giovanni di Dio Fatebenefratelli,Brescia,Italy
Degenhardt L:
National Drug and Alcohol Research Centre, University of New South Wales,Sydney,Australia
Gureje O:
Department of Psychiatry,University College Hospital,Ibadan,Nigeria
Haro JM:
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona,Barcelona,Spain
Huang Y:
Institute of Mental Health, Peking University,Beijing,China
Kawakami N:
Department of Mental Health,School of Public Health, The University of Tokyo,Tokyo,Japan
Lee S:
Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong
Navarro-Mateu F:
UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud IMIB-Arrixaca
CIBERESP-Murcia,Murcia,Spain
Pennell BE:
Survey Research Center, Institute for Social Research, University of Michigan,Ann Arbor, Michigan,USA
Piazza M:
Universidad Cayetano Heredia,Lima,Peru
Sampson N:
Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA
Ten Have M:
Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
Torres Y:
Center for Excellence on Research in Mental Health, CES University,Medellin,Colombia
C Viana M:
Department of Social Medicine,Federal University of Espírito Santo,Vitoria,Brazil
Williams D:
Department of Society, Human Development, and Health,Harvard School of Public Health,Boston, Massaschusetts,USA
Xavier M:
Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas,Universidade Nova de Lisboa,Lisbon,Portugal
Kessler RC:
Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA
Open Access
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