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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS</title><author><name sortKey="Karam, Elie G" sort="Karam, Elie G" uniqKey="Karam E" first="Elie G." last="Karam">Elie G. Karam</name><affiliation><nlm:aff id="A1">Department of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon</nlm:aff></affiliation></author><author><name sortKey="Friedman, Matthew J" sort="Friedman, Matthew J" uniqKey="Friedman M" first="Matthew J." last="Friedman">Matthew J. Friedman</name><affiliation><nlm:aff id="A2">U.S. Department of Veterans Affairs, National Center for PTSD, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire</nlm:aff></affiliation></author><author><name sortKey="Hill, Eric D" sort="Hill, Eric D" uniqKey="Hill E" first="Eric D." last="Hill">Eric D. Hill</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Kessler, Ronald C" sort="Kessler, Ronald C" uniqKey="Kessler R" first="Ronald C." last="Kessler">Ronald C. Kessler</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Mclaughlin, Katie A" sort="Mclaughlin, Katie A" uniqKey="Mclaughlin K" first="Katie A." last="Mclaughlin">Katie A. Mclaughlin</name><affiliation><nlm:aff id="A4">Division of General Pediatrics, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Petukhova, Maria" sort="Petukhova, Maria" uniqKey="Petukhova M" first="Maria" last="Petukhova">Maria Petukhova</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Sampson, Laura" sort="Sampson, Laura" uniqKey="Sampson L" first="Laura" last="Sampson">Laura Sampson</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Shahly, Victoria" sort="Shahly, Victoria" uniqKey="Shahly V" first="Victoria" last="Shahly">Victoria Shahly</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Angermeyer, Matthias C" sort="Angermeyer, Matthias C" uniqKey="Angermeyer M" first="Matthias C." last="Angermeyer">Matthias C. Angermeyer</name><affiliation><nlm:aff id="A5">Center for Public Mental Health, Gösing am Wagram, Austria</nlm:aff></affiliation></author><author><name sortKey="Bromet, Evelyn J" sort="Bromet, Evelyn J" uniqKey="Bromet E" first="Evelyn J." last="Bromet">Evelyn J. Bromet</name><affiliation><nlm:aff id="A6">Department of Psychiatry, State University of New York at Stony Brook, Stony Brook, New York</nlm:aff></affiliation></author><author><name sortKey="De Girolamo, Giovanni" sort="De Girolamo, Giovanni" uniqKey="De Girolamo G" first="Giovanni" last="De Girolamo">Giovanni De Girolamo</name><affiliation><nlm:aff id="A7">IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Bologna, Italy</nlm:aff></affiliation></author><author><name sortKey="De Graaf, Ron" sort="De Graaf, Ron" uniqKey="De Graaf R" first="Ron" last="De Graaf">Ron De Graaf</name><affiliation><nlm:aff id="A8">Netherlands Institute of Mental Health and Addiction, the Netherlands</nlm:aff></affiliation></author><author><name sortKey="Demyttenaere, Koen" sort="Demyttenaere, Koen" uniqKey="Demyttenaere K" first="Koen" last="Demyttenaere">Koen Demyttenaere</name><affiliation><nlm:aff id="A9">Department of Psychiatry, University Hospital Gasthuisberg, University Hospital, Leuven, Belgium</nlm:aff></affiliation></author><author><name sortKey="Ferry, Finola" sort="Ferry, Finola" uniqKey="Ferry F" first="Finola" last="Ferry">Finola Ferry</name><affiliation><nlm:aff id="A10">MRC Trial Methodology Hub, Bamford Centre for Mental Health and Wellbeing, University of Ulster, Londonderry, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Florescu, Silvia E" sort="Florescu, Silvia E" uniqKey="Florescu S" first="Silvia E." last="Florescu">Silvia E. Florescu</name><affiliation><nlm:aff id="A11">Public Health Research and Evidence Based Medicine Department, National School of Public Health and Health Services Management, Bucharest, Romania</nlm:aff></affiliation></author><author><name sortKey="Haro, Josep Maria" sort="Haro, Josep Maria" uniqKey="Haro J" first="Josep Maria" last="Haro">Josep Maria Haro</name><affiliation><nlm:aff id="A12">Parc Sanitari Sant Joan de Déu, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="He, Yanling" sort="He, Yanling" uniqKey="He Y" first="Yanling" last="He">Yanling He</name><affiliation><nlm:aff id="A13">Department of Clinical Epidemiology, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China</nlm:aff></affiliation></author><author><name sortKey="Karam, Aimee N" sort="Karam, Aimee N" uniqKey="Karam A" first="Aimee N." last="Karam">Aimee N. Karam</name><affiliation><nlm:aff id="A1">Department of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon</nlm:aff></affiliation></author><author><name sortKey="Kawakami, Norito" sort="Kawakami, Norito" uniqKey="Kawakami N" first="Norito" last="Kawakami">Norito Kawakami</name><affiliation><nlm:aff id="A14">Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan</nlm:aff></affiliation></author><author><name sortKey="Kovess Masfety, Viviane" sort="Kovess Masfety, Viviane" uniqKey="Kovess Masfety V" first="Viviane" last="Kovess-Masfety">Viviane Kovess-Masfety</name><affiliation><nlm:aff id="A15">Department of Epidemiology, EHESP School for Public Health, Université Paris Descartes, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Medina Mora, Maria Elena" sort="Medina Mora, Maria Elena" uniqKey="Medina Mora M" first="María Elena" last="Medina-Mora">María Elena Medina-Mora</name><affiliation><nlm:aff id="A16">National Institute of Psychiatry, Mexico City, Mexico</nlm:aff></affiliation></author><author><name sortKey="Browne, Mark A Oakley" sort="Browne, Mark A Oakley" uniqKey="Browne M" first="Mark A. Oakley" last="Browne">Mark A. Oakley Browne</name><affiliation><nlm:aff id="A17">Statewide and Mental Health Services, Department of Health and Human Services, Tasmania, Australia</nlm:aff></affiliation></author><author><name sortKey="Posada Villa, Jose A" sort="Posada Villa, Jose A" uniqKey="Posada Villa J" first="José A." last="Posada-Villa">José A. Posada-Villa</name><affiliation><nlm:aff id="A18">Instituto Colombiano del Sistema Nervioso, Bogota, D.C., Colombia</nlm:aff></affiliation></author><author><name sortKey="Shalev, Arieh Y" sort="Shalev, Arieh Y" uniqKey="Shalev A" first="Arieh Y." last="Shalev">Arieh Y. Shalev</name><affiliation><nlm:aff id="A19">Department of Psychiatry, Hadassah University Hospital, Kiriat Hadassah, Jerusalem, Israel</nlm:aff></affiliation></author><author><name sortKey="Stein, Dan J" sort="Stein, Dan J" uniqKey="Stein D" first="Dan J." last="Stein">Dan J. Stein</name><affiliation><nlm:aff id="A20">Department of Psychiatry, University of Cape Town, Cape Town, South Africa</nlm:aff></affiliation></author><author><name sortKey="Viana, Maria Carmen" sort="Viana, Maria Carmen" uniqKey="Viana M" first="Maria Carmen" last="Viana">Maria Carmen Viana</name><affiliation><nlm:aff id="A21">Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitoria, Espírito Santo, Brazil</nlm:aff></affiliation></author><author><name sortKey="Zarkov, Zahari" sort="Zarkov, Zahari" uniqKey="Zarkov Z" first="Zahari" last="Zarkov">Zahari Zarkov</name><affiliation><nlm:aff id="A22">Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria</nlm:aff></affiliation></author><author><name sortKey="Koenen, Karestan C" sort="Koenen, Karestan C" uniqKey="Koenen K" first="Karestan C." last="Koenen">Karestan C. Koenen</name><affiliation><nlm:aff id="A23">Psychiatric-Neurological Epidemiology Cluster Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23983056</idno><idno type="pmc">4085043</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085043</idno><idno type="RBID">PMC:4085043</idno><idno type="doi">10.1002/da.22169</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">002206</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002206</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS</title><author><name sortKey="Karam, Elie G" sort="Karam, Elie G" uniqKey="Karam E" first="Elie G." last="Karam">Elie G. Karam</name><affiliation><nlm:aff id="A1">Department of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon</nlm:aff></affiliation></author><author><name sortKey="Friedman, Matthew J" sort="Friedman, Matthew J" uniqKey="Friedman M" first="Matthew J." last="Friedman">Matthew J. Friedman</name><affiliation><nlm:aff id="A2">U.S. Department of Veterans Affairs, National Center for PTSD, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire</nlm:aff></affiliation></author><author><name sortKey="Hill, Eric D" sort="Hill, Eric D" uniqKey="Hill E" first="Eric D." last="Hill">Eric D. Hill</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Kessler, Ronald C" sort="Kessler, Ronald C" uniqKey="Kessler R" first="Ronald C." last="Kessler">Ronald C. Kessler</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Mclaughlin, Katie A" sort="Mclaughlin, Katie A" uniqKey="Mclaughlin K" first="Katie A." last="Mclaughlin">Katie A. Mclaughlin</name><affiliation><nlm:aff id="A4">Division of General Pediatrics, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Petukhova, Maria" sort="Petukhova, Maria" uniqKey="Petukhova M" first="Maria" last="Petukhova">Maria Petukhova</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Sampson, Laura" sort="Sampson, Laura" uniqKey="Sampson L" first="Laura" last="Sampson">Laura Sampson</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Shahly, Victoria" sort="Shahly, Victoria" uniqKey="Shahly V" first="Victoria" last="Shahly">Victoria Shahly</name><affiliation><nlm:aff id="A3">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Angermeyer, Matthias C" sort="Angermeyer, Matthias C" uniqKey="Angermeyer M" first="Matthias C." last="Angermeyer">Matthias C. Angermeyer</name><affiliation><nlm:aff id="A5">Center for Public Mental Health, Gösing am Wagram, Austria</nlm:aff></affiliation></author><author><name sortKey="Bromet, Evelyn J" sort="Bromet, Evelyn J" uniqKey="Bromet E" first="Evelyn J." last="Bromet">Evelyn J. Bromet</name><affiliation><nlm:aff id="A6">Department of Psychiatry, State University of New York at Stony Brook, Stony Brook, New York</nlm:aff></affiliation></author><author><name sortKey="De Girolamo, Giovanni" sort="De Girolamo, Giovanni" uniqKey="De Girolamo G" first="Giovanni" last="De Girolamo">Giovanni De Girolamo</name><affiliation><nlm:aff id="A7">IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Bologna, Italy</nlm:aff></affiliation></author><author><name sortKey="De Graaf, Ron" sort="De Graaf, Ron" uniqKey="De Graaf R" first="Ron" last="De Graaf">Ron De Graaf</name><affiliation><nlm:aff id="A8">Netherlands Institute of Mental Health and Addiction, the Netherlands</nlm:aff></affiliation></author><author><name sortKey="Demyttenaere, Koen" sort="Demyttenaere, Koen" uniqKey="Demyttenaere K" first="Koen" last="Demyttenaere">Koen Demyttenaere</name><affiliation><nlm:aff id="A9">Department of Psychiatry, University Hospital Gasthuisberg, University Hospital, Leuven, Belgium</nlm:aff></affiliation></author><author><name sortKey="Ferry, Finola" sort="Ferry, Finola" uniqKey="Ferry F" first="Finola" last="Ferry">Finola Ferry</name><affiliation><nlm:aff id="A10">MRC Trial Methodology Hub, Bamford Centre for Mental Health and Wellbeing, University of Ulster, Londonderry, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Florescu, Silvia E" sort="Florescu, Silvia E" uniqKey="Florescu S" first="Silvia E." last="Florescu">Silvia E. Florescu</name><affiliation><nlm:aff id="A11">Public Health Research and Evidence Based Medicine Department, National School of Public Health and Health Services Management, Bucharest, Romania</nlm:aff></affiliation></author><author><name sortKey="Haro, Josep Maria" sort="Haro, Josep Maria" uniqKey="Haro J" first="Josep Maria" last="Haro">Josep Maria Haro</name><affiliation><nlm:aff id="A12">Parc Sanitari Sant Joan de Déu, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="He, Yanling" sort="He, Yanling" uniqKey="He Y" first="Yanling" last="He">Yanling He</name><affiliation><nlm:aff id="A13">Department of Clinical Epidemiology, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China</nlm:aff></affiliation></author><author><name sortKey="Karam, Aimee N" sort="Karam, Aimee N" uniqKey="Karam A" first="Aimee N." last="Karam">Aimee N. Karam</name><affiliation><nlm:aff id="A1">Department of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon</nlm:aff></affiliation></author><author><name sortKey="Kawakami, Norito" sort="Kawakami, Norito" uniqKey="Kawakami N" first="Norito" last="Kawakami">Norito Kawakami</name><affiliation><nlm:aff id="A14">Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan</nlm:aff></affiliation></author><author><name sortKey="Kovess Masfety, Viviane" sort="Kovess Masfety, Viviane" uniqKey="Kovess Masfety V" first="Viviane" last="Kovess-Masfety">Viviane Kovess-Masfety</name><affiliation><nlm:aff id="A15">Department of Epidemiology, EHESP School for Public Health, Université Paris Descartes, Paris, France</nlm:aff></affiliation></author><author><name sortKey="Medina Mora, Maria Elena" sort="Medina Mora, Maria Elena" uniqKey="Medina Mora M" first="María Elena" last="Medina-Mora">María Elena Medina-Mora</name><affiliation><nlm:aff id="A16">National Institute of Psychiatry, Mexico City, Mexico</nlm:aff></affiliation></author><author><name sortKey="Browne, Mark A Oakley" sort="Browne, Mark A Oakley" uniqKey="Browne M" first="Mark A. Oakley" last="Browne">Mark A. Oakley Browne</name><affiliation><nlm:aff id="A17">Statewide and Mental Health Services, Department of Health and Human Services, Tasmania, Australia</nlm:aff></affiliation></author><author><name sortKey="Posada Villa, Jose A" sort="Posada Villa, Jose A" uniqKey="Posada Villa J" first="José A." last="Posada-Villa">José A. Posada-Villa</name><affiliation><nlm:aff id="A18">Instituto Colombiano del Sistema Nervioso, Bogota, D.C., Colombia</nlm:aff></affiliation></author><author><name sortKey="Shalev, Arieh Y" sort="Shalev, Arieh Y" uniqKey="Shalev A" first="Arieh Y." last="Shalev">Arieh Y. Shalev</name><affiliation><nlm:aff id="A19">Department of Psychiatry, Hadassah University Hospital, Kiriat Hadassah, Jerusalem, Israel</nlm:aff></affiliation></author><author><name sortKey="Stein, Dan J" sort="Stein, Dan J" uniqKey="Stein D" first="Dan J." last="Stein">Dan J. Stein</name><affiliation><nlm:aff id="A20">Department of Psychiatry, University of Cape Town, Cape Town, South Africa</nlm:aff></affiliation></author><author><name sortKey="Viana, Maria Carmen" sort="Viana, Maria Carmen" uniqKey="Viana M" first="Maria Carmen" last="Viana">Maria Carmen Viana</name><affiliation><nlm:aff id="A21">Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitoria, Espírito Santo, Brazil</nlm:aff></affiliation></author><author><name sortKey="Zarkov, Zahari" sort="Zarkov, Zahari" uniqKey="Zarkov Z" first="Zahari" last="Zarkov">Zahari Zarkov</name><affiliation><nlm:aff id="A22">Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria</nlm:aff></affiliation></author><author><name sortKey="Koenen, Karestan C" sort="Koenen, Karestan C" uniqKey="Koenen K" first="Karestan C." last="Koenen">Karestan C. Koenen</name><affiliation><nlm:aff id="A23">Psychiatric-Neurological Epidemiology Cluster Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York</nlm:aff></affiliation></author></analytic><series><title level="j">Depression and anxiety</title><idno type="ISSN">1091-4269</idno><idno type="eISSN">1520-6394</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts.</p></sec><sec id="S3"><title>Results</title><p id="P3">19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9708816</journal-id><journal-id journal-id-type="pubmed-jr-id">20612</journal-id><journal-id journal-id-type="nlm-ta">Depress Anxiety</journal-id><journal-id journal-id-type="iso-abbrev">Depress Anxiety</journal-id><journal-title-group><journal-title>Depression and anxiety</journal-title></journal-title-group><issn pub-type="ppub">1091-4269</issn><issn pub-type="epub">1520-6394</issn></journal-meta><article-meta><article-id pub-id-type="pmid">23983056</article-id><article-id pub-id-type="pmc">4085043</article-id><article-id pub-id-type="doi">10.1002/da.22169</article-id><article-id pub-id-type="manuscript">NIHMS592543</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Karam</surname><given-names>Elie G.</given-names></name><degrees>M.D</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Friedman</surname><given-names>Matthew J.</given-names></name><degrees>M.D., Ph.D</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Hill</surname><given-names>Eric D.</given-names></name><degrees>M.S.P.H</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Kessler</surname><given-names>Ronald C.</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>McLaughlin</surname><given-names>Katie A.</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Petukhova</surname><given-names>Maria</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Sampson</surname><given-names>Laura</given-names></name><degrees>B.A</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Shahly</surname><given-names>Victoria</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Angermeyer</surname><given-names>Matthias C.</given-names></name><degrees>M.D</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Bromet</surname><given-names>Evelyn J.</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>de Girolamo</surname><given-names>Giovanni</given-names></name><degrees>M.D</degrees><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>de Graaf</surname><given-names>Ron</given-names></name><degrees>Ph.D., M.Sc</degrees><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Demyttenaere</surname><given-names>Koen</given-names></name><degrees>M.D., Ph.D</degrees><xref ref-type="aff" rid="A9">9</xref></contrib><contrib contrib-type="author"><name><surname>Ferry</surname><given-names>Finola</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A10">10</xref></contrib><contrib contrib-type="author"><name><surname>Florescu</surname><given-names>Silvia E.</given-names></name><degrees>M.D., Ph.D</degrees><xref ref-type="aff" rid="A11">11</xref></contrib><contrib contrib-type="author"><name><surname>Haro</surname><given-names>Josep Maria</given-names></name><degrees>M.D., Ph.D., M.P.H</degrees><xref ref-type="aff" rid="A12">12</xref></contrib><contrib contrib-type="author"><name><surname>He</surname><given-names>Yanling</given-names></name><degrees>M.D., Mint. M.H</degrees><xref ref-type="aff" rid="A13">13</xref></contrib><contrib contrib-type="author"><name><surname>Karam</surname><given-names>Aimee N.</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kawakami</surname><given-names>Norito</given-names></name><degrees>M.D., D.M.Sc</degrees><xref ref-type="aff" rid="A14">14</xref></contrib><contrib contrib-type="author"><name><surname>Kovess-Masfety</surname><given-names>Viviane</given-names></name><degrees>M.D., Ph.D</degrees><xref ref-type="aff" rid="A15">15</xref></contrib><contrib contrib-type="author"><name><surname>Medina-Mora</surname><given-names>María Elena</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A16">16</xref></contrib><contrib contrib-type="author"><name><surname>Browne</surname><given-names>Mark A. Oakley</given-names></name><degrees>F.R.A.N.Z.C.P., Ph.D</degrees><xref ref-type="aff" rid="A17">17</xref></contrib><contrib contrib-type="author"><name><surname>Posada-Villa</surname><given-names>José A.</given-names></name><degrees>M.D</degrees><xref ref-type="aff" rid="A18">18</xref></contrib><contrib contrib-type="author"><name><surname>Shalev</surname><given-names>Arieh Y.</given-names></name><degrees>M.D</degrees><xref ref-type="aff" rid="A19">19</xref></contrib><contrib contrib-type="author"><name><surname>Stein</surname><given-names>Dan J.</given-names></name><degrees>M.D., Ph.D</degrees><xref ref-type="aff" rid="A20">20</xref></contrib><contrib contrib-type="author"><name><surname>Viana</surname><given-names>Maria Carmen</given-names></name><degrees>M.D., Ph.D</degrees><xref ref-type="aff" rid="A21">21</xref></contrib><contrib contrib-type="author"><name><surname>Zarkov</surname><given-names>Zahari</given-names></name><degrees>M.D</degrees><xref ref-type="aff" rid="A22">22</xref></contrib><contrib contrib-type="author"><name><surname>Koenen</surname><given-names>Karestan C.</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A23">23</xref><xref ref-type="corresp" rid="CR1">*</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon</aff><aff id="A2"><label>2</label>U.S. Department of Veterans Affairs, National Center for PTSD, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire</aff><aff id="A3"><label>3</label>Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</aff><aff id="A4"><label>4</label>Division of General Pediatrics, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts</aff><aff id="A5"><label>5</label>Center for Public Mental Health, Gösing am Wagram, Austria</aff><aff id="A6"><label>6</label>Department of Psychiatry, State University of New York at Stony Brook, Stony Brook, New York</aff><aff id="A7"><label>7</label>IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Bologna, Italy</aff><aff id="A8"><label>8</label>Netherlands Institute of Mental Health and Addiction, the Netherlands</aff><aff id="A9"><label>9</label>Department of Psychiatry, University Hospital Gasthuisberg, University Hospital, Leuven, Belgium</aff><aff id="A10"><label>10</label>MRC Trial Methodology Hub, Bamford Centre for Mental Health and Wellbeing, University of Ulster, Londonderry, United Kingdom</aff><aff id="A11"><label>11</label>Public Health Research and Evidence Based Medicine Department, National School of Public Health and Health Services Management, Bucharest, Romania</aff><aff id="A12"><label>12</label>Parc Sanitari Sant Joan de Déu, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain</aff><aff id="A13"><label>13</label>Department of Clinical Epidemiology, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China</aff><aff id="A14"><label>14</label>Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan</aff><aff id="A15"><label>15</label>Department of Epidemiology, EHESP School for Public Health, Université Paris Descartes, Paris, France</aff><aff id="A16"><label>16</label>National Institute of Psychiatry, Mexico City, Mexico</aff><aff id="A17"><label>17</label>Statewide and Mental Health Services, Department of Health and Human Services, Tasmania, Australia</aff><aff id="A18"><label>18</label>Instituto Colombiano del Sistema Nervioso, Bogota, D.C., Colombia</aff><aff id="A19"><label>19</label>Department of Psychiatry, Hadassah University Hospital, Kiriat Hadassah, Jerusalem, Israel</aff><aff id="A20"><label>20</label>Department of Psychiatry, University of Cape Town, Cape Town, South Africa</aff><aff id="A21"><label>21</label>Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitoria, Espírito Santo, Brazil</aff><aff id="A22"><label>22</label>Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria</aff><aff id="A23"><label>23</label>Psychiatric-Neurological Epidemiology Cluster Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York</aff><author-notes><corresp id="CR1"><label>*</label>Correspondence to: Karestan C. Koenen, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 720G, New York, NY 10032. <email>kck5@mail.cumc.columbia.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>6</day><month>6</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>27</day><month>8</month><year>2013</year></pub-date><pub-date pub-type="ppub"><month>2</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>07</day><month>7</month><year>2014</year></pub-date><volume>31</volume><issue>2</issue><fpage>130</fpage><lpage>142</lpage><pmc-comment>elocation-id from pubmed: 10.1002/da.22169</pmc-comment>
<permissions><copyright-statement>© 2013 Wiley Periodicals, Inc.</copyright-statement><copyright-year>2013</copyright-year></permissions><abstract><sec id="S1"><title>Background</title><p id="P1">Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts.</p></sec><sec id="S3"><title>Results</title><p id="P3">19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014.</p></sec></abstract><kwd-group><kwd>PTSD</kwd><kwd>functional impairment</kwd><kwd>comorbidity</kwd><kwd>World Mental Health Surveys</kwd><kwd>epidemiology</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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