Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys

AJ Rosellini, H Liu, MV Petukhova, NA Sampson, S Aguilar-Gaxiola, J Alonso, G Borges, R Bruffaerts, E. J. Bromet, G de Girolamo, P. de Jonge, J Fayyad, S Florescu, O Gureje, J.M. Haro, H Hinkov, EG Karam, N Kawakami, KC Koenen, S Lee & 14 others J.-P. Lépine, D Levinson, F Navarro-Mateu, BD Oladeji, Siobhan O'Neill, BE Pennell, M Piazza, J Posada-Villa, KM Scott, DJ Stein, Y Torres, MC Viana, AM Zaslavsky, RC Kessler

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within six months, a majority within two 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 1,575 respondents with lifetime PTSD.
Results: 20%, 27%, and 50% of cases recovered within three, six, 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 (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 odds-ratios 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% versus 43%) and later-recovery (75-68% versus 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.
LanguageEnglish
Pages437-450
JournalPsychological Medicine
Volume48
Issue number3
Early online date19 Jul 2017
DOIs
Publication statusPublished - Feb 2018

Fingerprint

Post-Traumatic Stress Disorders
Health Surveys
Diagnostic and Statistical Manual of Mental Disorders
Mental Health
Wounds and Injuries
Mental Disorders
Survival Analysis
Global Health
Violence
Odds Ratio
Research

Keywords

  • Cross-national
  • epidemiology
  • post-traumatic stress disorder
  • recovery

Cite this

Rosellini, AJ., Liu, H., Petukhova, MV., Sampson, NA., Aguilar-Gaxiola, S., Alonso, J., ... Kessler, RC. (2018). Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. Psychological Medicine, 48(3), 437-450. https://doi.org/10.1017/S0033291717001817
Rosellini, AJ ; Liu, H ; Petukhova, MV ; Sampson, NA ; 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, EG ; Kawakami, N ; Koenen, KC ; Lee, S ; Lépine, J.-P. ; Levinson, D ; Navarro-Mateu, F ; Oladeji, BD ; O'Neill, Siobhan ; Pennell, BE ; Piazza, M ; Posada-Villa, J ; Scott, KM ; Stein, DJ ; Torres, Y ; Viana, MC ; Zaslavsky, AM ; Kessler, RC. / Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. In: Psychological Medicine. 2018 ; Vol. 48, No. 3. pp. 437-450.
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abstract = "Background: Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within six months, a majority within two 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 1,575 respondents with lifetime PTSD. Results: 20{\%}, 27{\%}, and 50{\%} of cases recovered within three, six, 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 (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 odds-ratios 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{\%} versus 43{\%}) and later-recovery (75-68{\%} versus 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.",
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author = "AJ Rosellini and H Liu and MV Petukhova and NA Sampson and S Aguilar-Gaxiola and J Alonso and G Borges and R Bruffaerts and Bromet, {E. J.} and {de Girolamo}, G and {de Jonge}, P. and J Fayyad and S Florescu and O Gureje and J.M. Haro and H Hinkov and EG Karam and N Kawakami and KC Koenen and S Lee and J.-P. L{\'e}pine and D Levinson and F Navarro-Mateu and BD Oladeji and Siobhan O'Neill and BE Pennell and M Piazza and J Posada-Villa and KM Scott and DJ Stein and Y Torres and MC Viana and AM Zaslavsky and RC Kessler",
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Rosellini, AJ, Liu, H, Petukhova, MV, Sampson, NA, Aguilar-Gaxiola, S, Alonso, J, Borges, G, Bruffaerts, R, Bromet, EJ, de Girolamo, G, de Jonge, P, Fayyad, J, Florescu, S, Gureje, O, Haro, JM, Hinkov, H, Karam, EG, Kawakami, N, Koenen, KC, Lee, S, Lépine, J-P, Levinson, D, Navarro-Mateu, F, Oladeji, BD, O'Neill, S, Pennell, BE, Piazza, M, Posada-Villa, J, Scott, KM, Stein, DJ, Torres, Y, Viana, MC, Zaslavsky, AM & Kessler, RC 2018, 'Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys', Psychological Medicine, vol. 48, no. 3, pp. 437-450. https://doi.org/10.1017/S0033291717001817

Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. / Rosellini, AJ; Liu, H; Petukhova, MV; Sampson, NA; 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, EG; Kawakami, N; Koenen, KC; Lee, S; Lépine, J.-P.; Levinson, D; Navarro-Mateu, F; Oladeji, BD; O'Neill, Siobhan; Pennell, BE; Piazza, M; Posada-Villa, J; Scott, KM; Stein, DJ; Torres, Y; Viana, MC; Zaslavsky, AM; Kessler, RC.

In: Psychological Medicine, Vol. 48, No. 3, 02.2018, p. 437-450.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys

AU - Rosellini, AJ

AU - Liu, H

AU - Petukhova, MV

AU - Sampson, NA

AU - Aguilar-Gaxiola, S

AU - Alonso, J

AU - Borges, G

AU - Bruffaerts, R

AU - Bromet, E. J.

AU - de Girolamo, G

AU - de Jonge, P.

AU - Fayyad, J

AU - Florescu, S

AU - Gureje, O

AU - Haro, J.M.

AU - Hinkov, H

AU - Karam, EG

AU - Kawakami, N

AU - Koenen, KC

AU - Lee, S

AU - Lépine, J.-P.

AU - Levinson, D

AU - Navarro-Mateu, F

AU - Oladeji, BD

AU - O'Neill, Siobhan

AU - Pennell, BE

AU - Piazza, M

AU - Posada-Villa, J

AU - Scott, KM

AU - Stein, DJ

AU - Torres, Y

AU - Viana, MC

AU - Zaslavsky, AM

AU - Kessler, RC

PY - 2018/2

Y1 - 2018/2

N2 - Background: Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within six months, a majority within two 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 1,575 respondents with lifetime PTSD. Results: 20%, 27%, and 50% of cases recovered within three, six, 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 (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 odds-ratios 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% versus 43%) and later-recovery (75-68% versus 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.

AB - Background: Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within six months, a majority within two 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 1,575 respondents with lifetime PTSD. Results: 20%, 27%, and 50% of cases recovered within three, six, 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 (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 odds-ratios 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% versus 43%) and later-recovery (75-68% versus 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.

KW - Cross-national

KW - epidemiology

KW - post-traumatic stress disorder

KW - recovery

U2 - 10.1017/S0033291717001817

DO - 10.1017/S0033291717001817

M3 - Article

VL - 48

SP - 437

EP - 450

JO - Psychological Medicine

T2 - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 3

ER -

Rosellini AJ, Liu H, Petukhova MV, Sampson NA, Aguilar-Gaxiola S, Alonso J et al. Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. Psychological Medicine. 2018 Feb;48(3):437-450. https://doi.org/10.1017/S0033291717001817