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Trauma, post-traumatic stress disorder and psychiatric disorders in a middle-income setting: prevalence and
Sarah Dorrington1, Helena Zavos1, Harriet Ball1
1Sarah Dorrington, Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK; Helena Zavos, PhD, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK; Harriet Ball, PhD, BMBCh, Faculty of Medicine, Imperial College London, UK; Peter McGuffin, PhD, Fruhling Rijsdijk, PhD, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK; Sisira Siribaddana, MBBS, MD, Department of Medicine Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, and Institute of Research and Development Sri Lanka; Athula Sumathipala, MD, PhD, Research Institute for Primary Care and Health Sciences, Keele University, and Department of Health Service and Population Research, King's College London Honorary Director, and Institute for Research and Development Sri Lanka; Matthew Hotopf, PhD, Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK.
Background:
Most studies of post-traumatic stress disorder (PTSD) in low- and middle-income countries (LMICs) have focused on 'high-risk' populations defined by exposure to trauma.
Aims:
To estimate the prevalence of post-traumatic stress disorder (PTSD) in a LMIC, the conditional probability of PTSD given a traumatic event and the strength of associations between traumatic events and other psychiatric disorders.
Method:
Our sample contained a mix of 3995 twins and 2019 non-twins. We asked participants about nine different traumatic exposures, including the category 'other', but excluding sexual trauma.
Results:
Traumatic events were reported by 36.3% of participants and lifetime PTSD was present in 2.0%. Prevalence of non-PTSD lifetime diagnosis was 19.1%. Of people who had experienced three or more traumatic events, 13.3% had lifetime PTSD and 40.4% had a non-PTSD psychiatric diagnosis.
Conclusions:
Despite high rates of exposure to trauma, this population had lower rates of PTSD than high-income populations, although the prevalence might have been slightly affected by the exclusion of sexual trauma. There are high rates of non-PTSD diagnoses associated with trauma exposure that could be considered in interventions for trauma-exposed populations. Our findings suggest that there is no unique relationship between traumatic experiences and the specific symptomatology of PTSD.
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