Naslov
Disorder of Extreme StressNot Othervise Clasified ( DESNOS) in Croatian War Veterans with Posttraumatic Stress Disorder (case control study)
(Disorder of Extreme StressNot Othervise Clasified ( DESNOS) in Croatian War Veterans with Posttraumatic Stress Disorder ( case control study))

Autori
Nemčić Moro, Iva ; Frančišković, Tanja ; Britvić, Dolores ; Klarić, Miro ; Zečević, Iva

Izvornik
Croatian medical journal (0353-9504) 52 (2011), 4; 505-512

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Posttraumatic Stress Disorder (PTSD); Disorder of Extreme Stress Not Otherwise Specified (DESNOS); complex PTSD; veterans; comorbidity; depression; panic disorder; social phobia.

Sažetak
Certain clinical entities are being reassessed regarding the preparation of new editions of the DSM and ICD classifications of diseases. Among others, clinical entities under reexamination are Disorder of Extreme Stress Not Otherwise Specified (DESNOS) or Complex PTSD according to the classification of the American Psychiatric Association. The corresponding diagnostic entity of the ICD would be Enduring Personality Change After Catastrophic Experience, which, according to definitions, occurs as a psychological effect of psychotraumatization and excludes the presence of PTSD. Day-to-day clinical practice casts doubts as to the view that PTSD and DESNOS/EPCACE symptoms are mutually exclusive. Aim was to determine possible presence of Disorders of Extreme Stress Not Otherwise Specified (DESNOS) in Croatian war veterans who suffer from combat-related Posttraumatic Stress Disorder (PTSD). The research included 247 participants in four clinical centers in Croatia. 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 International Neuropsychiatric Interview (MINI). 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 veterans of the Homeland War in Croatia who suffer from PTSD met criteria for DESNOS. By comparing the group with both PTSD and DESNOS and the group with PTSD only we obtained a statistically significant difference regarding the intensity of posttraumatic symptoms (U=3733.5, p<0.01). Persons who suffer both from PTSD and DESNOS report traumatic symptoms of a higher intensity, they suffer from a significantly larger number of mental disorders in comorbidity (U=1123.5, p<0.05) and twice more frequently suffer from comorbid depression with melancholic features (OR=2.109, p<0.05), social phobia (OR=2.137, p<0.05) or panic disorder (OR=2.208, p<0.05). The research 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 treatment processes.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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