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1.
Depress Anxiety ; 31(2): 130-42, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23983056

RESUMEN

BACKGROUND: Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. METHODS: Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n = 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. RESULTS: 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyperarousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. CONCLUSIONS: A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more "complex" clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies.


Asunto(s)
Encuestas Epidemiológicas/estadística & datos numéricos , Internacionalidad , Acontecimientos que Cambian la Vida , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Estrés Psicológico/epidemiología , Adolescente , Adulto , Edad de Inicio , Niño , Comorbilidad , Europa (Continente)/epidemiología , Femenino , Encuestas Epidemiológicas/métodos , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Prevalencia , Factores de Riesgo , Estrés Psicológico/psicología , Estados Unidos/epidemiología , Adulto Joven
2.
Aust N Z J Psychiatry ; 40(10): 845-54, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16959010

RESUMEN

OBJECTIVE: To estimate the 12 month prevalence of DSM-IV disorders in New Zealand, and associated interference with life and severity. METHOD: A nationally representative face-to-face household survey carried out in 2003-2004. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12,992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper the outcomes reported are 12 month prevalence, interference with life and severity for individual disorders. RESULTS: The prevalence of any disorder in the past 12 months was 20.7%. The prevalences for disorder groups were: anxiety disorders 14.8%, mood disorders 7.9%, substance use disorders 3.5%, eating disorders 0.5%. The highest prevalences for individual disorders were for specific phobia (7.3%), major depressive disorder (5.7%) and social phobia (5.1%). Interference with life was higher for mood disorders than for anxiety disorders. Drug dependence, bipolar disorder and dysthymia had the highest proportion of severe cases (over 50%), when severity was assessed over the disorder itself and all comorbid disorders. Overall, only 31.7% of cases were classified as mild with 45.6% moderate and 22.7% serious. CONCLUSIONS: Compared with other World Mental Health survey sites New Zealand has relatively high prevalences, although almost always a little lower than for the US. For all disorders, except specific phobia, interference with life was reported to be moderate, on average, which has lead to less than a third of cases being classified as mild. Most people who have ever met full DSM-IV criteria, including the impairment criterion, and who experience symptoms or an episode in the past 12 months find that their disorders impact on their lives to a non-trivial extent.


Asunto(s)
Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Calidad de Vida/psicología , Perfil de Impacto de Enfermedad , Áreas de Influencia de Salud , Evaluación de la Discapacidad , Humanos , Incidencia , Nueva Zelanda/epidemiología , Prevalencia , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Factores de Tiempo
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