title: Frequency of trauma exposure and Post-Traumatic Stress Disorder in Italy: analysis from the World Mental Health Survey Initiative.
abstract: Epidemiological studies have examined the relative importance of Traumatic Events (TEs) in accounting for the societal burden of post-traumatic stress disorder (PTSD). However, most studies used the worst trauma experienced, which can lead to an overestimation of the conditional risk of PTSD. Although a number of epidemiological surveys on PTSD have been carried out in the United States, only a few studies in limited sample have been conducted in Italy. This study, carried out in the framework of the World Mental Health Survey Initiative, is a cross-sectional household survey of a representative sample of the Italian adult population. Lifetime prevalence of TEs and 12-month prevalence of PTSD were evaluated using the Composite International Diagnostic Interview (CIDI). Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE. Network events was the most commonly reported class of TEs (29.4%). War events had the highest conditional risk of PTSD (12.2%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (24.1%) and having seen atrocities (18.2%). Being female was related to high risk of PTSD after experiencing a TE. Exposure to network events is commonly reported among Italian adults, but two TEs are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden.
authors.affiliation: Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Italy. Electronic address: ccarmassi@gmail.com.
authors.forename: Claudia
authors.initials: C
authors.lastname: Carmassi
authors.affiliation: Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Italy. Electronic address: liliana.dellosso@med.unipi.it.
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
authors.affiliation: Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Italy. Electronic address: corrado3@live.it.
authors.forename: Corrado
authors.initials: C
authors.lastname: Manni
authors.affiliation: IRCCS St John of God Clinical Research Centre, Via Pilastroni 4, 25125 Brescia, Italy. Electronic address: vcandini@fatebenefratelli.it.
authors.forename: Valentina
authors.initials: V
authors.lastname: Candini
authors.affiliation: IRCCS St John of God Clinical Research Centre, Via Pilastroni 4, 25125 Brescia, Italy. Electronic address: jdagani@fatebenefratelli.it.
authors.forename: Jessica
authors.initials: J
authors.lastname: Dagani
authors.affiliation: IRCCS St John of God Clinical Research Centre, Via Pilastroni 4, 25125 Brescia, Italy. Electronic address: liozzino@fatebenefratelli.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Iozzino
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 720G, New York, NY 10032, USA. Electronic address: kck5@mail.cumc.columbia.edu.
authors.forename: Karestan C
authors.initials: KC
authors.lastname: Koenen
authors.affiliation: IRCCS St John of God Clinical Research Centre, Via Pilastroni 4, 25125 Brescia, Italy. Electronic address: gdegirolamo@fatebenefratelli.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult
keywords: Epidemiology; Exposure; PTSD; Trauma