Post-traumatic stress disorder in adult victims of cluster munitions in Lebanon: a 10-year longitudinal study

被引:31
作者
Fares, Jawad [1 ,2 ]
Gebeily, Souheil [1 ,3 ]
Saad, Mohamad [1 ,4 ]
Harati, Hayat [1 ]
Nabha, Sanaa [1 ]
Said, Najwane [1 ]
Kanso, Mohamad [1 ,5 ]
Rassou, Ronza Abdel [1 ,6 ]
Fares, Youssef [1 ,7 ]
机构
[1] Lebanese Univ, Neurosci Res Ctr, Fac Med Sci, Beirut, Lebanon
[2] Amer Univ Beirut, Fac Med, Beirut, Lebanon
[3] Lebanese Univ, Fac Med Sci, Dept Neurol, Beirut, Lebanon
[4] Univ Washington, Dept Biostat, Div Stat Genet, Seattle, WA 98195 USA
[5] Amer Univ, Beirut Med Ctr, Dept Emergency Med, Beirut, Lebanon
[6] Hop Robert Debre, Inst Natl Sante & Rech Med, UMR 1141, Paris, France
[7] Lebanese Univ, Dept Neurosurg, Fac Med Sci, Beirut, Lebanon
关键词
TRAUMATIC BRAIN-INJURY; PRECLINICAL MEDICAL-STUDENTS; SOUTH LEBANON; WAR VETERANS; PRIMARY-CARE; PSYCHOLOGICAL IMPACT; VIETNAM VETERANS; MENTAL-HEALTH; MAJOR TRAUMA; RISK-FACTORS;
D O I
10.1136/bmjopen-2017-017214
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective This study aims to explore the short-term and long-term prevalence and effects of post-traumatic stress disorder (PTSD) among victims of cluster munitions. Design and setting A prospective 10-year longitudinal study that took place in Lebanon. Participants Two-hundred-and-forty-four Lebanese civilian victims of submunition blasts, who were injured in 2006 and were over 18 years old, were interviewed. Included were participants who had been diagnosed with PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and the PTSD Checklist-Civilian Version in 2006. Interviewees were present for the 10-year follow-up. Main outcome measures PTSD prevalence rates of participants in 2006 and 2016 were compared. Analysis of the demographical data pertaining to the association of long-term PTSD with other variables was performed. p Values <0.05 were considered statistically significant for all analyses (95% CI). Results All the 244 civilians injured by cluster munitions in 2006 responded, and were present for long-term follow-up in 2016. The prevalence of PTSD decreased significantly from 98% to 43% after 10 years (p<0.001). A lower long-term prevalence was significantly associated with male sex (p<0.001), family support (p<0.001) and religion (p<0.001). Hospitalisation (p=0.005) and severe functional impairment (p<0.001) post-trauma were significantly associated with increased prevalence of long-term PTSD. Symptoms of negative cognition and mood were more common in the long run. In addition, job instability was the most frequent socioeconomic repercussion among the participants (88%). Conclusions Psychological symptoms, especially PTSD, remain high in war-affected populations many years after the war; this is particularly evident for Lebanese civilians who were victimised by cluster munitions. Screening programmes and psychological interventions need to be implemented in vulnerable populations exposed to war traumas. Officials and public health advocates should consider the socioeconomic implications, and help raise awareness against the harm induced by cluster munitions and similar weaponry.
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页数:8
相关论文
共 59 条
[1]   Epidemiology and clinical characteristics of traumatic brain injury in Lebanon A systematic review [J].
Abou-Abbass, Hussein ;
Bahmad, Hisham ;
Ghandour, Hiba ;
Fares, Jawad ;
Wazzi-Mkahal, Rayyan ;
Yacoub, Basel ;
Darwish, Hala ;
Mondello, Stefania ;
Harati, Hayat ;
El Sayed, Mazen J. ;
Tamim, Hani ;
Kobeissy, Firas .
MEDICINE, 2016, 95 (47)
[2]  
[Anonymous], 2008, ANN M INT SOC TRAUM
[3]   Psychiatric and cognitive effects of war in former Yugoslavia - Association of lack of redress for trauma and posttraumatic stress reactions [J].
Basoglu, M ;
Livanou, M ;
Crnobaric, C ;
Franciskovic, T ;
Suljic, E ;
Duric, D ;
Vranesic, M .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (05) :580-590
[4]   Inflammation and Elevation of Interleukin-12p40 in Patients with Schizophrenia [J].
Bedrossian, Nora ;
Haidar, Mariam ;
Fares, Jawad ;
Kobeissy, Firas H. ;
Fares, Youssef .
FRONTIERS IN MOLECULAR NEUROSCIENCE, 2016, 9
[5]  
Beehner Lionel., 2006, BACKGROUNDER
[6]   Validating the primary care posttraumatic stress disorder screen and the posttraumatic stress disorder checklist with soldiers returning from combat [J].
Bliese, Paul D. ;
Wright, Kathleen M. ;
Adler, Amy B. ;
Cabrera, Oscar ;
Castro, Carl A. ;
Hoge, Charles W. .
JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY, 2008, 76 (02) :272-281
[7]   Posttraumatic stress disorder and physical illness - Results from clinical and epidemiologic studies [J].
Boscarino, JA .
BIOBEHAVIORAL STRESS RESPONSE: PROTECTIVE AND DAMAGING EFFECTS, 2004, 1032 :141-153
[8]   Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults [J].
Brewin, CR ;
Andrews, B ;
Valentine, JD .
JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY, 2000, 68 (05) :748-766
[9]   Stress among black women in a South African township: The protective role of religion [J].
Copeland-Linder, Nikeea .
JOURNAL OF COMMUNITY PSYCHOLOGY, 2006, 34 (05) :577-599
[10]   Lifetime events and posttraumatic stress disorder in 4 postconflict settings [J].
de Jong, JTVM ;
Komproe, IH ;
Van Ommeren, M ;
El Masri, M ;
Araya, M ;
Khaled, N ;
van de Put, W ;
Somasundaram, D .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 286 (05) :555-562