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Post-traumatic stress disorder and major depression in conflict-affected populations: an epidemiological model and predictor analysis.

作者信息

Charlson F J, Flaxman A, Ferrari A J, Vos T, Steel Z, Whiteford H A

机构信息

University of Queensland, School of Public Health, Herston, QLD, Australia.

Queensland Centre for Mental Health Research, Wacol, QLD, Australia.

出版信息

Glob Ment Health (Camb). 2016 Feb 10;3:e4. doi: 10.1017/gmh.2015.26. eCollection 2016.


DOI:10.1017/gmh.2015.26
PMID:28596873
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5314754/
Abstract

BACKGROUND: Despite significant research examining mental health in conflict-affected populations we do not yet have a comprehensive epidemiological model of how mental disorders are distributed, or which factors influence the epidemiology in these populations. We aim to derive prevalence estimates specific for region, age and sex of major depression, and PTSD in the general populations of areas exposed to conflict, whilst controlling for an extensive range of covariates. METHODS: A systematic review was conducted to identify epidemiological estimates of depression and PTSD in conflict-affected populations and potential predictors. We analyse data using Bayesian meta-regression techniques. RESULTS: We identified 83 studies and a list of 34 potential predictors. The age-standardised pooled prevalence of PTSD was 12.9% (95% UI 6.9-22.9), and major depression 7.6% (95% UI 5.1-10.9) - markedly lower than estimated in previous research but over two-times higher than the mean prevalence estimated by the Global Burden of Disease Study [3.7% (95% UI 3.0-4.5) and 3.5% (95% UI 2.9-4.2) for anxiety disorders and MDD, respectively]. The age-patterns reveal sharp prevalence inclines in the childhood years. A number of ecological variables demonstrated associations with prevalence of both disorders. Symptom scales were shown to significantly overestimate prevalence of both disorders. Finding suggests higher prevalence of both disorders in females. CONCLUSION: This study provides, for the first time, age-specific estimates of PTSD and depression prevalence adjusted for an extensive range of covariates and is a significant advancement on our current understanding of the epidemiology in conflict-affected populations.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/5314754/cfb137f1eb77/S2054425115000266_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/5314754/a8b5cf476385/S2054425115000266_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/5314754/cfb137f1eb77/S2054425115000266_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/5314754/a8b5cf476385/S2054425115000266_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/5314754/cfb137f1eb77/S2054425115000266_fig2.jpg

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本文引用的文献

[1]
Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Lancet. 2015-8-22

[2]
Mental and substance use disorders in Sub-Saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years.

PLoS One. 2014-10-13

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The global burden of anxiety disorders in 2010.

Psychol Med. 2014-8

[4]
Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.

Lancet. 2013-8-29

[5]
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Depress Anxiety. 2013-8-27

[6]
The epidemiological modelling of major depressive disorder: application for the Global Burden of Disease Study 2010.

PLoS One. 2013-7-29

[7]
The epidemiological modelling of dysthymia: application for the Global Burden of Disease Study 2010.

J Affect Disord. 2013-6-24

[8]
Global health. The global prevalence of intimate partner violence against women.

Science. 2013-6-28

[9]
Asylum seekers, violence and health: a systematic review of research in high-income host countries.

Am J Public Health. 2013-1-17

[10]
Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

Lancet. 2012-12-15

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