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Trauma, post-traumatic stress disorder and psychiatric disorders in a middle-income setting: prevalence and comorbidity

  • Sarah Dorrington (a1), Helena Zavos (a2), Harriet Ball (a3), Peter McGuffin (a2), Fruhling Rijsdijk (a2), Sisira Siribaddana (a4), Athula Sumathipala (a5) and Matthew Hotopf (a1)...

Abstract

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.

Copyright and usage

© Royal College of Psychiatrists 2014. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.

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Copyright

Corresponding author

Matthew Hotopf, Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, Cutcombe Rd, London SE5 9RJ. Email: matthew.hotopf@kcl.ac.uk

Footnotes

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Declaration of interest

M.H. receives salary support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and is Director of the Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Footnotes

References

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Supplementary Table S1

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Trauma, post-traumatic stress disorder and psychiatric disorders in a middle-income setting: prevalence and comorbidity

  • Sarah Dorrington (a1), Helena Zavos (a2), Harriet Ball (a3), Peter McGuffin (a2), Fruhling Rijsdijk (a2), Sisira Siribaddana (a4), Athula Sumathipala (a5) and Matthew Hotopf (a1)...
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