Common etiological factors of PTSD in post-war Bosnia and Herzegovina

Posttraumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to one or more traumatic events that threatened or caused severe physical harm. According to World Health Organization (WHO) at least a million people in the Bosnia-Herzegovina suffer from PTSD, or other stress related disorders caused by war (1992-1995). The aim of this paper is to elucidate the etiology of Post-traumatic Stress Disorder among the persons admitted to the Psychiatric Department of the Clinical Centre of University of Sarajevo during 2008/2009, and to isolate the most common etiological factors of PTSD among these patients based on the differentiated etiological factors and genders. Materials and methods: The research carried out April 2008-October 2009 is epidemiological, retrospective-prospective type, of analytic-descriptive feature, based on observation and analysis of relevant variables. All PTSD subjects (343) who were treated because of PTSD, were included in this research. Diagnose was made according to the DSM-IV criteria for PTSD. We have recorded demographic variables (gender, age, education, marital status, employment and profession). The traumatic factors were observed, analyzed and presented. We have statistically analyzed all collected data. We have been comparing all above mentioned demographic variables, traumatic factors and genders of treated patients. As research instrument we have been using: Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). HTQ (Harvard Trauma Questionnaire) and Risk Factors Checklist. Results: Of the 343 subjects the disorder manifested most commonly among high educated, married and unemployed males who had experienced multiple traumatic events. The most dominant traumatic event was confiscation or destruction of personal property (32.1%). The serious war wounds (27,9%) were the next dominant traumatic event, while the eyewitness of innocent persons injury have taken the third place. (21.3%), the least frequent traumatic events correlates to sexual humiliation and torture (0.9%). Nearly all patients with PTSD experienced more than one etiological stressor (96%).