Jukić Melita, Filaković Pavo, Požgain Ivan, Glavina Trpimir
Department of Psychiatry of the County General, Hospital Vukovar and Croatian Veterans' Hospital, Županijska ulica 35, HR-32000, Vukovar, Croatia,
Psychiatr Danub. 2019 Jun;31(2):189-200. doi: 10.24869/psyd.2019.189.
War captivity is one of the most difficult human experiences and can cause long-lasting effects on mental and physical health. Posttraumatic Stress Disorder (PTSD), as one of the frequent consequences of war trauma, is often associated with the psychiatric and/or somatic comorbidity. Therefore, PTSD results in impaired Health-Related Quality of Life (HRQoL). This study aimed to investigate the HRQoL in the Croatian Homeland War ex-POWs affected by PTSD, regarding the intensity of PTSD symptoms, sociodemographic characteristics and somatic comorbidity, and to identify predictors of poor HRQoL.
The study sample consisted of two groups (45 participants each) based on whether they were POWs or not (control group). All study participants were diagnosed with PTSD according to the ICD-10 criteria and had combat experience as active participants in defence of the Republic of Croatia during the Homeland War. The subjects were evaluated using the sociodemographic questionnaire, PTSD self-report checklist (PCL-5) and Short Form (SF-36) Health Survey questionnaire. The data on participants' physical diseases were collected from medical anamnesis and medical records in the last five years.
In relation to ex-POWs, the control group had significantly smaller number of retirees, more unemployed persons, smaller number of married subjects, and higher number of divorced persons. Low socioeconomic status and intensity of PTSD symptoms has been confirmed as a significant predictor of impaired HRQoL in both subject groups. The most commonly PTSD associated physical diseases were musculosceletal, cardiovascular, and gastrointestinal diseases. Endocrine and metabolic diseases were more frequent in the ex-POWs' group.
PTSD was associated with the HRQoL, whether the veterans were ex-POWs or not. The hypothesis that exposure of ex-POWs to the trauma of captivity experience impaired HRQoL to a greater extent, compared to the non-detained veterans, was not confirmed. Low socioeconomic status has proved to be the most significant predictor of poorer HRQoL.
战争囚禁是最艰难的人类经历之一，会对身心健康造成长期影响。创伤后应激障碍（PTSD）作为战争创伤的常见后果之一，常与精神和/或躯体合并症相关。因此，PTSD会导致健康相关生活质量（HRQoL）受损。本研究旨在调查受PTSD影响的克罗地亚祖国战争前战俘的HRQoL，涉及PTSD症状强度、社会人口学特征和躯体合并症，并确定HRQoL差的预测因素。
根据是否为战俘（对照组），研究样本分为两组（每组45名参与者）。所有研究参与者均根据ICD-10标准被诊断为PTSD，且在祖国战争期间作为克罗地亚共和国防御的积极参与者有战斗经历。使用社会人口学问卷、PTSD自我报告清单（PCL-5）和简短健康调查问卷（SF-36）对受试者进行评估。从过去五年的医疗病史和病历中收集参与者身体疾病的数据。
与前战俘相比，对照组退休人员数量显著更少，失业人员更多，已婚受试者数量更少，离婚人员数量更多。低社会经济地位和PTSD症状强度已被确认为两组受试者HRQoL受损的重要预测因素。与PTSD最常相关的身体疾病是肌肉骨骼疾病、心血管疾病和胃肠道疾病。内分泌和代谢疾病在前战俘组中更为常见。
无论退伍军人是否为前战俘，PTSD都与HRQoL相关。前战俘因囚禁经历的创伤而使HRQoL受损程度比未被拘留的退伍军人更大这一假设未得到证实。低社会经济地位已被证明是HRQoL较差的最显著预测因素。
