title: Impact of war trauma and posttraumatic stress disorder on psychopathology in Croatian and German patients with severe mental illness.
abstract: OBJECTIVE
  To explore posttraumatic stress symptoms and current psychopathology in a binational sample of Croatian and German participants with severe mental illness.
  
  
  METHODS
  We studied 178 inpatients from the Greifswald University (German patients, n=89) and University Hospital Zagreb and Ivan Barbot Neuropsychiatric Hospital (Croatian patients, n=89) with either major depression (n=150), schizophrenia (n=26), or bipolar disorder (n=2). Measurements included Posttraumatic Diagnostic Scale and the Symptom Check List-90-R. Participants were matched according to age, sex, and diagnosis.
  
  
  RESULTS
  Croatians reported significantly more war traumatic events (64/82 vs 5/74, chi(2)(1)=77.142, P<0.001) and significantly more Croatians met the criteria for posttraumatic stress disorder (55/89 vs 27/89, chi(2)(1)=17.73, P<0.001). They also suffered from a higher level of psychopathological distress as they scored significantly higher at all Symptom Check List-90-R revised version subscales (P<0.001). The regression models demonstrated that predictors of general psychopathological distress were war trauma (P<0.001), posttraumatic stress disorder (P<0.001), and diagnosis (P=0.01).
  
  
  CONCLUSIONS
  This is the first study comparing the impact of war trauma on psychopathology of participants with severe mental illness between two nations. Our results clearly indicate the importance of trauma assessment in subjects with severe mental illness, particularly in post-conflict settings.
authors.affiliation: University of Zagreb, Medical School, University Hospital Center Zagreb, Department of Psychiatry, Kispaticeva 12, Zagreb, Croatia. nikolina.jovanovic@gmail.com
authors.forename: Nikolina
authors.initials: N
authors.lastname: Jovanović
authors.forename: Philipp
authors.initials: P
authors.lastname: Kuwert
authors.forename: Iris
authors.initials: I
authors.lastname: Sarajlic Vuković
authors.forename: Dasa
authors.initials: D
authors.lastname: Poredos Lavor
authors.forename: Vesna
authors.initials: V
authors.lastname: Medved
authors.forename: Marina
authors.initials: M
authors.lastname: Kovac
authors.forename: Carsten
authors.initials: C
authors.lastname: Spitzer
authors.forename: Manuela
authors.initials: M
authors.lastname: Dudeck
authors.forename: Matthias
authors.initials: M
authors.lastname: Vogel
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Freyberger
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Grabe
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology; D015897:Comorbidity; D017523:Croatia / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D015999:Multivariate Analysis; D012559:Schizophrenia / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014857:Warfare
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