title: Trauma exposure, PTSD and psychotic-like symptoms in post-conflict Timor Leste: an epidemiological survey.
abstract: BACKGROUND
  Studies in developed countries indicate that psychotic-like symptoms are prevalent in the community and are related to trauma exposure and PTSD. No comparable studies have been undertaken in low-income, post-conflict countries. This study aimed to assess the prevalence of psychotic-like symptoms in conflict-affected Timor Leste and to examine whether symptoms were associated with trauma and PTSD.
  
  
  METHODS
  The Psychosis Screening Questionnaire and the Harvard Trauma Questionnaire (assessing trauma exposure and PTSD) were administered in an epidemiological survey of 1245 adults (response rate 80.6%) in a rural and an urban setting in Timor Leste. We defined PSQ screen-positive cases as those people reporting at least one psychotic-like symptom (paranoia, hallucinations, strange experiences, thought interference, hypomania).
  
  
  RESULTS
  The prevalence of PSQ screen-positive cases was 12 percent and these persons were more disabled. PSQ cases were more likely to reside in the urban area, experienced higher levels of trauma exposure and a greater prevalence of PTSD. PTSD only partially mediated the relationship between trauma exposure and psychotic-like symptoms.
  
  
  CONCLUSIONS
  Psychotic-like symptoms may be prevalent in countries exposed to mass conflict. The cultural and contextual meaning of psychotic-like symptoms requires further inquiry in low-income, post-conflict settings such as Timor Leste.
authors.affiliation: Department of Psychological Medicine, University of Auckland, Auckland, New Zealand. i.soosay@auckland.ac.nz
authors.forename: Ian
authors.initials: I
authors.lastname: Soosay
authors.forename: Derrick
authors.initials: D
authors.lastname: Silove
authors.forename: Catherine
authors.initials: C
authors.lastname: Bateman-Steel
authors.forename: Zachary
authors.initials: Z
authors.lastname: Steel
authors.forename: Paul
authors.initials: P
authors.lastname: Bebbington
authors.forename: Peter B
authors.initials: PB
authors.lastname: Jones
authors.forename: Tien
authors.initials: T
authors.lastname: Chey
authors.forename: Lorraine
authors.initials: L
authors.lastname: Ivancic
authors.forename: Claire
authors.initials: C
authors.lastname: Marnane
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000523:psychology; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D049648:Timor-Leste / Q000453:epidemiology; D014857:Warfare