Injured civilian survivors of suicide bomb attacks: from partial PTSD to recovery or to traumatisation. Where is the turning point?
OBJECTIVE
To assess the short- (3-9 months) and medium-term (30 months) occurrence and severity of post-traumatic stress disorder (PTSD) in civilian survivors of suicide bombing terrorist attacks.


METHODS
We evaluated 129 injured survivors of nine attacks in Israel who were treated in our emergency room between June 2000 and September 2002. Data on demographics, physical injuries and psychiatric symptoms were collected by both a structured clinical interview and standard assessment scales for depression, anxiety, and sleep quality. Diagnosis of PTSD was based on a Hebrew-validated DSM-IV SCID-PTSD rating scale.


RESULTS
At the first assessment (short-term), 20 survivors (15.5%) met the criteria for full-blown PTSD and 54 (42%) for sub-clinical PTSD, while 55 (42.5%) evidenced no symptoms of PTSD. Two years later, only 54 patients could be located: 19 (35%) of them had either persistent or de novo PTSD and none had residual sub-clinical PTSD.


CONCLUSIONS
Relatively few survivors of suicide bomb attacks had full-blown PTSD, while a substantial number of survivors had short-term sub-clinical PTSD. Two-year follow-up evaluations revealed that a significant a number of the patients available for testing (35%) had full-blown PTSD. These findings imply that medium-term follow-up of survivors is needed in order to establish the actual prevalence of PTSD.
Dolberg
Ornah T
OT
Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Barkai
Gabriel
G
Leor
Agnes
A
Rapoport
Helena
H
Bloch
Miki
M
Schreiber
Shaul
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D001753:Blast Injuries / Q000209:etiology / Q000523:psychology*; D054042:Bombs; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D013405:Suicide; D017741:Survivors / Q000523:psychology; D023481:Terrorism / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult