Trauma and suicidality in war affected communities.

PURPOSE: The aim was to assess whether experiences of war trauma remain directly associated with suicidality in war affected communities when other risk factors are considered. MATERIALS AND METHODS: In the main sample 3313 participants from former Yugoslavia who experienced war trauma were recruited using a random sampling in five Balkan countries. In the second sample 854 refugees from former Yugoslavia recruited through registers and networking in three Western European countries. Sociodemographic and data on trauma exposure, psychiatric diagnoses and level of suicidality were assessed. RESULTS: In the main sample 113 participants (3.4%) had high suicidality, which was associated with number of potentially traumatic war experiences (odds ratio 1.1) and war related imprisonment (odds ratio 3) once all measured risk factors were considered. These associations were confirmed in the refugee sample with a higher suicidality rate (10.2%). DISCUSSION AND CONCLUSIONS: Number of potentially traumatic war experiences, in particular imprisonment, may be considered as a relevant risk factor for suicidality in people affected by war.

Course of post-traumatic stress disorder following war in the Balkans: 1-year follow-up study.

BACKGROUND: Prevalence rates of post-traumatic stress disorder (PTSD) following the experience of war have been shown to be high. However, little is known about the course of the disorder in people who remained in the area of conflict and in refugees. Method We studied a representative sample of 522 adults with war-related PTSD in five Balkan countries and 215 compatriot refugees in three Western European countries. They were assessed on average 8 years after the war and reinterviewed 1 year later. We established change in PTSD symptoms, measured on the Impact of Events Scale - Revised (IES-R), and factors associated with more or less favourable outcomes. RESULTS: During the 1-year period, symptoms decreased substantially in both Balkan residents and in refugees. The differences were significant for IES-R total scores and for the three subscales of intrusions, avoidance and hyperarousal. In multivariable regressions adjusting for the level of baseline symptoms, co-morbidity with depression predicted less favourable symptom change in Balkan residents. More pre-war traumatic events and the use of mental health services within the follow-up period were associated with less improvement in refugees. CONCLUSIONS: Several years after the war, people with PTSD reported significant symptom improvement that might indicate a fluctuating course over time. Co-morbid depression may have to be targeted in the treatment of people who remained in the post-conflict regions whereas the use of mental health services seems to be linked to the persistence of symptoms among refugees.

In colchicine-treated rats, cellular distribution of AQP-1 in convoluted and straight proximal tubule segments is differently affected.

In cells along the nephron, the recycling of various components between the plasma membrane and intracellular organelles by vesicle trafficking depends on intact microtubules (MT). Previous studies of rats treated with the MT-disrupting drug colchicine showed that some brush-border membrane (BBM) transporters in renal proximal convoluted tubule cells (PCTC) become internalized in numerous vesicles randomly scattered in the cytoplasm. In this study, we compare the intracellular distribution of MT and several BBM proteins [megalin, vacuolar (V)-ATPase, water channel aquaporin-1 (AQP-1)] as well as endocytosis of the in-vivo-injected fluorescent marker FITC-dextran in PCTC and proximal straight tubule cells (PSTC) in control and colchicine-treated rats. Immunoblotting and immunocytochemical data show that in the PCTC and PSTC colchicine treatment causes: (1) disappearance of MT, (2) strongly diminished endocytosis of FITC-dextran, and (3) marked loss of megalin and V-ATPase from the BBM and their redistribution into intracellular vesicles. Similar pattern was observed for the distribution of AQP-1 in the PCTC. However, in the PSTC, the staining intensity of AQP-1 in the BBM, as well as its intracellular distribution remained unaffected by colchicine treatment. We conclude that in the PSTC, either MT play a minor role in the recycling of AQP-1 between the BBM and intracellular vesicles or BBM AQP-1 turns over much more slowly than in the PCTC.