Posttraumatic stress disorder in the World Mental Health Surveys

Bibliographic Data

ID23321004
AuthorsKarestan C Koenen (0000-0003-2978-7655, Harvard University, corresponding author), Andrew Ratanatharathorn (0000-0001-9855-0438, Columbia University), L Ng (0000-0002-8599-1186, Boston University), Katie A Mclaughlin (0000-0002-1362-2410, University of Washington), Evelyn J Bromet (0000-0002-2648-5793, Stony Brook University), Dan J Stein (0000-0001-7218-7810, University of Cape Town), Elie G Karam (0000-0002-4681-8225, University of Balamand), Ayelet Meron Ruscio (University of Pennsylvania), Corina Benjet (0000-0002-4569-6094, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz), Kate M Scott (0000-0002-3928-8377, University of Otago), K Scott (0000-0001-8360-3015), Lukoye Atwoli (0000-0001-7710-9723, Moi University), Maria Petukhova (0000-0002-0488-2384, Harvard University), Carmen C W Lim (0000-0003-1595-6307, The University of Queensland), Sergio Aguilar‐gaxiola (UC Davis Health System), S Aguilar-Gaxiola, A Al-Hamzawi (University of Al-Qadisiyah), Jordi Alonso (0000-0001-8627-9636, Universitat Pompeu Fabra), Brendan Bunting (0000-0002-7219-6773, University of Ulster), Marius Ciutan (National School of Public Health, Management and Professional Development), Giovanni De Girolamo (0000-0002-1611-8324, Centro San Giovanni di Dio Fatebenefratelli), Louisa Degenhardt (0000-0002-8513-2218, UNSW Sydney), Oye Gureje (0000-0003-0094-5947, University College Hospital, Ibadan), Josep Maria Haro (0000-0002-3984-277X, Centro de Investigación Biomédica en Red de Salud Mental), Yueqin Huang (0000-0001-5493-5838, Peking University), Norito Kawakami (0000-0003-1080-2720, University of Tokyo Health Sciences), S Lee (0000-0001-9257-9643, Chinese University of Hong Kong), F Navarro-Mateu, Fernando Navarro‐Mateu (0000-0002-3228-623X, Servicio Murciano de Salud), B-E Pennell, Marina Piazza (0000-0002-8446-6419, Universidad Peruana Cayetano Heredia), Nancy A Sampson (0000-0003-2971-6072, Harvard University), N Sampson, M ten Have (Trimbos Institute), Yisel Torres (0000-0002-6712-365X, Universidad CES), Maria Carmen Viana (0000-0002-0464-4845, Universidade Federal do Espírito Santo), D Williams (0000-0002-9774-2910, Harvard University), Miguel Xavier (0000-0003-2698-1284, University of Lisbon), R C Kessler (0000-0003-4831-2305, Harvard University)
Year2017
Volume47
Issue13
Pages2260-2274
Publication date2017-10-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePsychological Medicine (JOURNAL)
Journal identifiersISSN: 0033-2917 • E-ISSN: 1469-8978
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0033291717000708
PMID28385165
OpenAlexW2604674575
LanguageEN
Citations received116
References cited45

Background Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking. Methods Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics. Results The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed. Conclusions PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.

Disadvantage · Environmental health · Mental health · Population · Psychiatry · Respondent · Child Abuse and Trauma · Demography · Epidemiology · Medicine · Migration, Health and Trauma · Posttraumatic Stress Disorder Research · Psychology