Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. Issue 3 (19th July 2017)

• Record Type: Journal Article
• Authors: Rosellini, A. J.; Liu, H.; Petukhova, M. V.; Sampson, N. A.; Aguilar-Gaxiola, S.; Alonso, J.; Borges, G.; Bruffaerts, R.; Bromet, E. J.; de Girolamo, G.; de Jonge, P.; Fayyad, J.; Florescu, S.; Gureje, O.; Haro, J. M.; Hinkov, H.; Karam, E. G.; Kawakami, N.; Koenen, K. C.; Lee, S.; Lépine, J. P.; Levinson, D.; Navarro-Mateu, F.; Oladeji, B. D.; O'Neill, S.; Pennell, B.-E.; Piazza, M.; Posada-Villa, J.; Scott, K. M.; Stein, D. J.; Torres, Y.; Viana, M. C.; Zaslavsky, A. M.; Kessler, R. C.;
• Is Part Of: Psychological medicine. Volume 48:Issue 3(2018)
• Page Start: 437
• Page End: 450
• Publication Date: 2017-07-19
• Subjects: Cross-national, -- epidemiology, -- post-traumatic stress disorder, -- recovery; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291717001817
• Languages: English
• ISSNs: 0033-2917

Abstract

Abstract : Background: Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors. Methods: The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD. Results: 20%, 27%, and 50% of cases recovered within 3, 6, and 24 months and 77% within 10 years (the longest duration allowing stable estimates). Time-related recall bias was found largely for recoveries after 24 months. Recovery was weakly related to most trauma types other than very low [odds-ratio (OR) 0.2–0.3] early-recovery (within 24 months) associated with purposefully injuring/torturing/killing and witnessing atrocities and very low later-recovery (25+ months) associated with being kidnapped. The significant ORs for prior traumas, CAs, and mental disorders were generally inconsistent between early- and later-recovery models. Cross-validated versions of final models nonetheless discriminated significantly between the 50% of respondents with highest and lowest predicted probabilities of both early-recovery (66–55% v. 43%) and later-recovery (75–68% v. 39%). Conclusions: We found PTSD recovery trajectories similar to those in previous studies. The weak associations of pre-trauma factors with recovery, also consistent with previous studies, presumably are due to stronger influences of post-trauma factors.