title: Disorder of extreme stress not otherwise specified (DESNOS) in Croatian war veterans with posttraumatic stress disorder: case-control study.
abstract: OBJECTIVE
  To determine the presence of disorder of extreme stress not otherwise specified (DESNOS) in Croatian war veterans who suffer from combat-related posttraumatic stress disorder (PTSD).
  
  
  METHODS
  The research included 247 veterans of the 1991-1995 war in Croatia who suffered from PTSD and were psychiatrically examined at four clinical centers in Croatia during a month in 2008. It was based on the following self-assessment instruments: The Harvard Trauma Questionnaire (HTQ): Croatian Version, the Structured Interview for Disorder of Extreme Stress (SIDES-SR), and the Mini International Neuropsychiatric Interview (MINI).
  
  
  RESULTS
  Based on the SIDES-SR results, we formed two groups of participants: the group with PTSD (N=140) and the group with both PTSD and DESNOS (N=107). Forty three percent of participants met the criteria for DESNOS. There was a significant difference in the intensity of posttraumatic symptoms between the group with both PTSD and DESNOS and the group with PTSD only (U=3733.5, P=0.001). Respondents who suffered from both PTSD and DESNOS also reported a significantly larger number of comorbid mental disorders (U=1123.5, P=0.049) and twice more frequently reported comorbid depression with melancholic features (OR=2.109, P=0.043), social phobia (OR=2.137, P=0.036), or panic disorder (OR=2.208, P=0.015).
  
  
  CONCLUSIONS
  Our results demonstrate that PTSD and DESNOS can occur in comorbidity, which is in contrast with the ICD-10 criteria. A greater intensity of symptoms and a more frequent comorbidity with other psychiatric disorders, especially depression, panic disorder, and social phobia require additional therapy interventions in the treatment processes.
authors.affiliation: Department of Psychological Medicine, University Hospital Center Zagreb, Kispatićeva 12, 10 000 Zagreb, Croatia. iva.nemcic-moro@zg.t-com.hr
authors.forename: Iva
authors.initials: I
authors.lastname: Nemcić-Moro
authors.forename: Tanja
authors.initials: T
authors.lastname: Francisković
authors.forename: Dolores
authors.initials: D
authors.lastname: Britvić
authors.forename: Miro
authors.initials: M
authors.lastname: Klarić
authors.forename: Iva
authors.initials: I
authors.lastname: Zecević
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D017523:Croatia; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000523:psychology*; D013312:Stress, Physiological; D014728:Veterans / Q000523:psychology*; D014857:Warfare