PREVALENCE OF POST TRAUMATIC STRESS DISORDER AMONG BASRAH MEDICAL STUDENTS

Background Post traumatic stress disorder is an anxiety disorder characterized by the emergence of core symptoms of the disorder after exposure to an extreme traumatic experience. Traumatic events that may cause Post Traumatic Stress Disorder includes violent assault, kidnapping, sexual assault, torture, being a hostage, prisoner of war, experiencing a disaster, violent automobile accidents or getting a life threatening illness. Methodology A cross-sectional study was carried out to estimate the prevalence of trauma and probable Post Traumatic Stress Disorder among the students of Basrah Medical College in 2007. A sample of 60 students was selected randomly from each class. A special questionnaire form was developed for the purpose of the study, containing the self – rating inventory for Post Traumatic Stress Disorder. Results The results of the present study showed that 238 (66.1%) students had reported being exposed to traumatic event during their life. The percentage of females who were exposed to trauma was slightly higher than that of males (67.8% vs 64.4%). Out of the total studied students, 211 (58.6%) students fulfilled the symptom criteria for Post Traumatic Stress Disorder, thus assessed as probable Post Traumatic Stress Disorder. INTRODUCTION rauma and its psychiatric consequences normally gain attention in times of war and national disaster. World wars I and II were accompanied by descriptions of sequels to mental trauma that went under different names: shell shock syndrome, and war sailor syndrome and the Konzentrationslager syndrome (KZ syndrome). The concept of post traumatic stress disorder (PTSD) was introduced in Diagnostic and Statistical Manual of Mental Disorder-III (DSM-III) after the Vietnam war. Post traumatic stress disorder is an anxiety disorder characterized by the emergence of core symptoms of the disorder after exposure to an extreme traumatic experience. These traumatic experiences are relatively common, more than two thirds of persons in the general their lives, and up to one fifth of people in the United States may experience such an event in any given year, Traumatic events that may cause PTSD includes violent assault, kidnapping, sexual assault, torture, being a hostage, prisoner of war, experiencing a disaster, violent automobile accidents or getting a life threatening illness. Although most people encounter trauma over a lifetime, recent studies indicate that almost eight percent of Americans will experience PTSD at some time in their lives. Responses to such an experience include intense fear, helplessness, or horror. The core symptoms of PTSD include re-experiencing the traumatic event, avoidance of trauma-related stimuli, numbing of general responsiveness, and signs of increased arousal. For the diagnosis of PTSD to be given, these symptoms must cause clinically significant distress or impairment in one or more important areas of functioning. PTSD is emerging as a major public health problem worldwide. Epidemiological studies within Australia and America identified rates of PTSD within the general population as 1.3% (DSM-IV criteria), 3.3% International Classification of Mental and Behavioral Disorders 10 criteria (ICD 10 criteria), and 7.8% (DSM-III-R criteria). PTSD is believed to occur in all ages for substantial number of individuals with prevalence rate ranging from 3-58% in individuals exposed to highly traumatic events. In countries with high levels of T ________________________________________________________________________________________________MJBU, VOL 28, No.2, 2010 63 violence like the situation in Iraq in the last decades, the people are exposed to many types of trauma everyday (explosion, homicide, kidnapping, migration, an explosive laden cars), and in spite of these extremely violent situations, very few epidemiological studies regarding trauma and PTSD have been carried out in Iraq. [9,10] The aim of the present study is to estimate the prevalence of trauma and probable PTSD among Basrah medical students. METHODOLOGY A cross-sectional study was carried out to estimate the prevalence of trauma and probable PTSD among the students of Basrah Medical College in 2007. A sample of 60 students was selected randomly from each class ( a total of 360 students). A special questionnaire form was developed for the purpose of the study. It was self–administered, completed and returned by the involved students. It included information covering the following aspects; age, sex, place of residence, marital status, exposed to trauma or not, and types of trauma. The questionnaire also involved the self–rating inventory for Post Traumatic Stress Disorder, which was used in its 22 item diagnostic version in order to differentiate subjects with probable PTSD from those without. The items reflect the 17 PTSD core symptoms according to the B,C and D criteria in DSM-IV. All items were scored on a four point scale, measuring the intensity of each symptom, where three and four were judged as affirmative answers. If at least one item from B-criterion (the intrusion), three items from/the C-criterion (avoidance) and two items from the D-criterion (hyper arousal) were answered affirmatively, the person was assessed as afflicted with probable PTSD. Statistical Package of Social Sciences version 11 was used for analysis of data. Chi-squared test was used to determine association between different variables and P<0.05 was considered to be statistically significant. RESULTS The study involved 360 medical students, all of them responded to the study. Mean age was 23.2±1.6 years. Out of them 177(49.2%) were males and 183 (50.8%) were females. Table-1 shows, the prevalence of trauma among the studied students according to sex. Of all studied students, 238(66.1%) reported being exposed to traumatic events during their life; The percentage of females who were exposed to trauma was slightly higher than that of males (67.8% vs 64.4%), but no significant difference was noted. (Chi–square = 0.451, P-value = 0.502). Table 1. Prevalence of trauma among study students according to sex.