Sahlgrenska University Hospital, Goteborg, Västra Götaland Region, Sweden.
Queen Mary University of London, London, UK.
Int J Soc Psychiatry. 2021 Sep;67(6):770-778. doi: 10.1177/0020764020972433. Epub 2020 Nov 12.
Little is known about gender differences among people exposed to war related trauma. Aim of this study is to explore gender differences in health status and comorbidity of mental and physical disorders in a cohort of Bosnian refugees followed up for 3 years (1996-1999).
This longitudinal study included 534 subjects followed up for 3 years. The interviews were conducted in refugee camps in Varaždin, Croatia in Bosnian language. Data were collected using Harvard Trauma Questionnaire (Bosnian version) and Hopkins Checklist-25, respectively. Physical health disorders were self-reported.
In both assessments there was a statistically significant difference between men and women in the number of physical health disorders, even when results were controlled for educational status. Although there was no difference in total number of symptoms in both assessments ( = 0.32; = 1; > 0.05 and = 1.15; = 1; > 0.05), important physical health disorders were significantly more frequent among women than in men in different educational groups, namely high blood pressure and cardiovascular diseases, arthritis, and anaemia. Asthma, tuberculosis, cirrhosis of the liver, ulcer and epilepsy were more frequent in men than in women. There were no differences in frequencies of psychiatric disorders at baseline, but frequency of psychiatric disorders in women was higher at endpoint for uneducated respondents. There was significant difference compared to men in group of respondents without formal education, but only in comorbidity of PTSD and depression which was more often present in females (22.1%) than in males (3.6%).
Our findings indicate the importance of gender and education on mental and physical health of people exposed to warrelated trauma. Long term health monitoring and programs, especially related to women's health are needed in order to avoid lasting consequences.
对于经历过与战争相关创伤的人群中的性别差异知之甚少。本研究的目的是探讨在随访 3 年（1996-1999 年）的波斯尼亚难民队列中，健康状况和精神与身体障碍共病的性别差异。
这项纵向研究纳入了 534 名随访 3 年的受试者。访谈在克罗地亚 Varaždin 的难民营中以波斯尼亚语进行。数据分别使用哈佛创伤问卷（波斯尼亚语版）和霍普金斯检查表 25 收集。身体疾病由自我报告。
在两次评估中，男性和女性在身体疾病数量方面存在统计学上的显著差异，即使结果控制了教育程度。尽管在两次评估中总症状数没有差异（ = 0.32； = 1； > 0.05 和 = 1.15； = 1； > 0.05），但在不同教育群体中，女性的重要身体疾病比男性更为常见，即高血压和心血管疾病、关节炎和贫血。哮喘、肺结核、肝硬化、溃疡和癫痫在男性中比在女性中更为常见。在基线时，精神障碍的频率没有差异，但在未受过教育的受访者中，女性在终点时的精神障碍频率更高。与男性相比，未受过正规教育的受访者组存在显著差异，但仅在 PTSD 和抑郁共病方面，女性（22.1%）比男性（3.6%）更为常见。
我们的研究结果表明，性别和教育对经历过与战争相关创伤的人群的精神和身体健康具有重要影响。需要长期的健康监测和干预计划，特别是与妇女健康相关的计划，以避免持久的后果。
