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Social Psychiatry and Psychiatric Epidemiology

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01.10.2011 | Original Paper

Mental and physical health of Kosovar Albanians in their place of origin: a post-war 6-year follow-up study

verfasst von: Ariel Eytan, Ann Guthmiller, Sophie Durieux-Paillard, Louis Loutan, Marianne Gex-Fabry

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 10/2011

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Abstract

Purpose

Long-term outcome of traumatic experiences among war-exposed civilians living in their home country has been seldom documented. The present study examined change in posttraumatic stress disorder (PTSD) frequency and perceived physical and mental health in a cohort of Kosovar Albanians over 6 years (2001–2007).

Methods

Of 996 Albanian Kosovar civilians included in the 2001 survey, 551 subjects (55.3%) were recalled and interviewed in 2007. Diagnoses of PTSD and major depressive episode were assessed using the Mini International Neuropsychiatric Interview. Subjective physical and mental health were investigated using the Medical Outcomes Study 36-Item Short-Form (SF-36). A list of traumatic events adapted from the Harvard Trauma Questionnaire and other stressful life events was also considered.

Results

Posttraumatic stress disorder was significantly less frequent in 2007 than in 2001 (14.5% vs. 23.2%, p < 0.001). For 18.0, 5.3 and 9.3% of participants, PTSD remitted, persisted and developed over the 6-year follow-up period, respectively. Ill health without having access to medical care and major changes in responsibilities at work were associated with both persistence and new occurrence of PTSD. While the SF-36 mental component summary score significantly improved (mean change +4.5, p < 0.001), the physical component summary score did not change between 2001 and 2007, after adjustment for age (mean change −0.8, p = 0.14).

Conclusions

Results point at the importance of economic and health system reconstruction programs with respect to public health in post-conflict countries.

Eytan A et al (2006) Posttraumatic stress disorder and the use of general health services in postwar Kosovo. J Trauma Stress 19(1):57–67PubMedCrossRef

De Vries AK, Klazinga NS (2006) Mental health reform in post-conflict areas: a policy analysis based on experiences in Bosnia Herzegovina and Kosovo. Eur J Public Health 16(3):247–252PubMed

Ahern J et al (2004) Gender, social support, and posttraumatic stress in postwar Kosovo. J Nerv Ment Dis 192(11):762–770PubMedCrossRef

Lopes Cardozo B et al (2000) Mental health, social functioning, and attitudes of Kosovar Albanians following the war in Kosovo. Jama 284(5):569–577PubMedCrossRef

Eytan A et al (2004) Determinants of postconflict symptoms in Albanian Kosovars. J Nerv Ment Dis 192(10):664–671PubMedCrossRef

Kashdan TB, Morina N, Priebe S (2009) Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo war: experiential avoidance as a contributor to distress and quality of life. J Anxiety Disord 23(2):185–196PubMedCrossRef

Morina N (2007) The role of experiential avoidance in psychological functioning after war-related stress in Kosovar civilians. J Nerv Ment Dis 195(8):697–700PubMedCrossRef

Morina N, Ford JD (2008) Complex sequelae of psychological trauma among Kosovar civilian war victims. Int J Soc Psychiatry 54(5):425–436PubMedCrossRef

Morina N et al (2009) Somatic distress among Kosovar civilian war survivors: relationship to trauma exposure and the mediating role of experiential avoidance. Soc Psychiatry Psychiatr Epidemiol [Epub ahead of print]

10.

Ai AL, Peterson C, Ubelhor D (2002) War-related trauma and symptoms of posttraumatic stress disorder among adult Kosovar refugees. J Trauma Stress 15(2):157–160PubMedCrossRef

11.

Eytan A et al (2002) Screening of mental disorders in asylum-seekers from Kosovo. Aust N Z J Psychiatry 36(4):499–503PubMedCrossRef

12.

Gordon JS et al (2009) Treatment of posttraumatic stress disorder in postwar Kosovar adolescents using mind-body skills groups: a randomized controlled trial. J Clin Psychiatry

13.

Griffith JL et al (2005) A family-based mental health program of recovery from state terror in Kosova. Behav Sci Law 23(4):547–558PubMedCrossRef

14.

Weine SM et al (2003) The TAFES multi-family group intervention for Kosovar refugees: a feasibility study. J Nerv Ment Dis 191(2):100–107PubMedCrossRef

15.

Porter M, Haslam N (2001) Forced displacement in Yugoslavia: a meta-analysis of psychological consequences and their moderators. J Trauma Stress 14(4):817–834PubMedCrossRef

16.

Mollica RF et al (1999) Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia. Jama 282(5):433–439PubMedCrossRef

17.

Mollica RF et al (2001) Longitudinal study of psychiatric symptoms, disability, mortality, and emigration among Bosnian refugees. Jama 286(5):546–554PubMedCrossRef

18.

Kivling-Boden G, Sundbom E (2002) The relationship between post-traumatic symptoms and life in exile in a clinical group of refugees from the former Yugoslavia. Acta Psychiatr Scand 105(6):461–468PubMedCrossRef

19.

Momartin S et al (2003) Dimensions of trauma associated with posttraumatic stress disorder (PTSD) caseness, severity and functional impairment: a study of Bosnian refugees resettled in Australia. Soc Sci Med 57(5):775–781PubMedCrossRef

20.

Basoglu M et al (2005) Psychiatric and cognitive effects of war in former yugoslavia: association of lack of redress for trauma and posttraumatic stress reactions. Jama 294(5):580–590PubMedCrossRef

21.

Priebe S et al (2010) Mental disorders following war in the Balkans: a study in 5 countries. Arch Gen Psychiatry 67(5):518–528PubMedCrossRef

22.

Priebe S et al (2009) Consequences of untreated posttraumatic stress disorder following war in former Yugoslavia: morbidity, subjective quality of life, and care costs. Croat Med J 50(5):465–475PubMedCrossRef

23.

Roth G, Ekblad S, Agren H (2006) A longitudinal study of PTSD in a sample of adult mass-evacuated Kosovars, some of whom returned to their home country. Eur Psychiatry 21(3):152–159PubMedCrossRef

24.

Roth G, Ekblad S (2006) A longitudinal perspective on depression and sense of coherence in a sample of mass-evacuated adults from Kosovo. J Nerv Ment Dis 194(5):378–381PubMedCrossRef

25.

Foa EB, Stein DJ, McFarlane AC (2006) Symptomatology and psychopathology of mental health problems after disaster. J Clin Psychiatry 67(Suppl 2):15–25PubMed

26.

Badie B, Vidal D (2009) L’Etat du Monde. Les éditions du Boréal, Paris

27.

Sheehan DV et al (1998) The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59(Suppl 20):22–33 quiz 34-57PubMed

28.

APA (1994) Diagnostic and statistical manual of mental disorders, 4th edn. APA, Washington, DC

29.

OMS (1993) Classification internationale des maladies. Dixième révision. Chapitre V: troubles Mentaux et troubles du comportement. Masson, Paris

30.

Morina N (2006) Versioni Shqip (Albanian version of the) MINI. Zana, Prishtina

31.

Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. conceptual framework and item selection. Med Care 30(6):473–483PubMedCrossRef

32.

Leplège A et al (2001) Le questionnaire MOS SF-36, manuel de l’utilisateur et guide d’interprétation des scores. ESTEM editions, Paris

33.

Ware JE Jr et al (1998) The equivalence of SF-36 summary health scores estimated using standard and country-specific algorithms in 10 countries: results from the IQOLA project. international quality of Life assessment. J Clin Epidemiol 51(11):1167–1170PubMedCrossRef

34.

Mollica RF et al (1992) The harvard trauma questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis 180(2):111–116PubMedCrossRef

35.

Holmes TH, Rahe RH (1967) The social readjustment rating scale. J Psychosom Res 11(2):213–218PubMedCrossRef

36.

Kimhi S et al (2010) Postwar winners and losers in the long run: determinants of war related stress symptoms and posttraumatic growth. Commun Ment Health J 46(1):10–19CrossRef

37.

Hopman WM et al (2006) The natural progression of health-related quality of life: results of a five-year prospective study of SF-36 scores in a normative population. Qual Life Res 15(3):527–536PubMedCrossRef

38.

Davidson JR (2004) Long-term treatment and prevention of posttraumatic stress disorder. J Clin Psychiatry 65(Suppl 1):44–48PubMed

39.

Priebe S et al (2010) Treatment outcomes and costs at specialized centers for the treatment of PTSD after the war in former Yugoslavia. Psychiatr Serv 61(6):598–604PubMedCrossRef

40.

Sack M et al (2007) Trauma prevalence and somatoform symptoms: are there specific somatoform symptoms related to traumatic experiences? J Nerv Ment Dis 195(11):928–933PubMedCrossRef

41.

Weisberg RB et al (2002) Nonpsychiatric illness among primary care patients with trauma histories and posttraumatic stress disorder. Psychiatr Serv 53(7):848–854PubMedCrossRef

42.

Buwa D, Vuori H (2007) Rebuilding a health care system: war, reconstruction and health care reforms in Kosovo. Eur J Public Health 17(2):226–230PubMedCrossRef

43.

Boscarino JA (2008) Psychobiologic predictors of disease mortality after psychological trauma: implications for research and clinical surveillance. J Nerv Ment Dis 196(2):100–107PubMedCrossRef

44.

Cooke AL, Shear MK (2001) Treatment of a 50-year-old African American woman whose chronic posttraumatic stress disorder went undiagnosed for over 20 years. Am J Psychiatry 158(6):866–870PubMedCrossRef

45.

Mollica RF et al (1998) Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence. Br J Psychiatry 173:482–488PubMedCrossRef

46.

IOM (2008) Fact-sheet Kosovo

47.

Bloom JD et al (2007) Ethnic segregation in Kosovo’s post-war health care system. Eur J Public Health 17(5):430–436PubMedCrossRef

48.

Toscani L et al (2007) Health status of returnees to Kosovo: do living conditions during asylum make a difference? Public Health 121(1):34–44PubMedCrossRef

49.

Dobricki M et al (2010) Adjustment disorders after severe life-events in four postconflict settings. Soc Psychiatry Psychiatr Epidemiol 45(1):39–46PubMedCrossRef

50.

Andrews B et al (2007) Delayed-onset posttraumatic stress disorder: a systematic review of the evidence. Am J Psychiatry 164(9):1319–1326PubMedCrossRef

Titel: Mental and physical health of Kosovar Albanians in their place of origin: a post-war 6-year follow-up study
verfasst von: Ariel Eytan
Ann Guthmiller
Sophie Durieux-Paillard
Louis Loutan
Marianne Gex-Fabry
Publikationsdatum: 01.10.2011
Verlag: Springer-Verlag
Erschienen in: Social Psychiatry and Psychiatric Epidemiology / Ausgabe 10/2011
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-010-0269-0

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Purpose

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Conclusions

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