Impact of war trauma and posttraumatic stress disorder on psychopathology in Croatian and German patients with severe mental illness.
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.
Jovanović
Nikolina
N
University of Zagreb, Medical School, University Hospital Center Zagreb, Department of Psychiatry, Kispaticeva 12, Zagreb, Croatia. nikolina.jovanovic@gmail.com
Kuwert
Philipp
P
Sarajlic Vuković
Iris
I
Poredos Lavor
Dasa
D
Medved
Vesna
V
Kovac
Marina
M
Spitzer
Carsten
C
Dudeck
Manuela
M
Vogel
Matthias
M
Freyberger
Harald J
HJ
Grabe
Hans J
HJ
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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