Quality of life in war veterans with posttraumatic stress disorder comorbid with psychiatric and physical disturbances

Posttraumatski stresni poremećaj (PTSP) je učestali i često kronični poremećaj koji se javlja nakon iskustva ili svjedočenja životno ugrožavajućim događajima, a može biti civilni i ratni. U ovom istraživanju sudjelovali su branitelji koji su se borili u Domovinskom ratu te osobe bez ratnog iskustva. Jedna grupa branitelja imala je PTSP, dok druga grupa branitelja nije razvila PTSP, kao ni druge psihičke poremećaje. Međunarodnim strukturiranim neuropsihijatrijskim intervjuom (MINI) na hrvatskom jeziku dijagnosticirali su se psihijatrijski poremećaji. Na braniteljima kojima je dijagnosticiran PTSP primijenjena je i CAPS skala (engl. Clinican Administered PTSD Scale). Svi sudionici su ispunili upitnik kvalitete života WHOQOL-BREF te su prikupljeni podatci o tjelesnim bolestima koji su potvrđeni medicinskom dokumentacijom. Branitelji s PTSP-om i bez njega te osobe bez ratnog iskustva nisu se razlikovali po dobi i bračnom statusu, ali su osobe koje nisu sudjelovale u ratu bile značajno više obrazovane. Utvrđeno je da su branitelji s PTSP-om imali značajno sniženu kvalitetu života u svim domenama u odnosu na branitelje bez PTSP-a i sudionike koji nisu imali ratnog iskustva. 40 % branitelja koji su razvili PTSP imali su i druge psihičke komorbiditete, kao što su psihotični PTSP, depresija i anksiozni poremećaji te su imali više tjelesnih komorbiditeta od branitelja koji nisu razvili PTSP. Najčešće tjelesne bolesti kod oboljelih od PTSP-a su lokomotorne, kardiovaskularne, endokrinološke i gastrointestinalne. Psihički i tjelesni komorbiditet kod branitelja s PTSP-om značajno smanjuje sve aspekte kvalitete života. Jačina simptoma PTSP-a nije značajno povezana s domenama kvalitete života, ali je duljina liječenja značajno povezana sa simptomima izbjegavanja i obamrlosti u okviru kliničke slike PTSP-a, što znači da se branitelji s tim simptomima duže liječe. Prema našem saznanju ovo je prvo istraživanje povezanosti kvalitete života osoba oboljelih od PTSP koje imaju i psihički i tjelesni komorbiditet u Hrvatskoj, a prema dostupnoj literaturi, i u svijetu.Posttraumatic stress disorder (PTSD) is a frequent and often chronic disorder that emerges after one experienced or witnessed a life-threatening event and can be civil or war. The participants to this survey were the veterans who fought in the Homeland war and the people without any war experience. One group of veterans had the PTSD, while the other group of veterans did not develop PTSD or other psychological disorders. The psychiatric disorders were diagnosed by the International Neuropsychiatric Interview (MINI) in Croatian language. The Clinician Administered PTSD Scale was used on the veterans with a diagnosis of PTSD, too. The quality of life questionnaire WHOQOL-BREF was filled in by all the participants and the information about the physical illnesses, accompanied by the medical documentation, was collected. The veterans with or without PTSD and the people without any war experience did not differ in age or marital status, but the people who didn't participate in the war had significantly better education. It has been determined that the veterans with the PTSD had significantly lower quality of life in every domain compared with the veterans without the PTSD and the participants without any war experience. The 40% of veterans who had developed PTSD had other psychiatric comorbidities, as psychotic PTSD, depression, anxiety disorders and had more physical comorbidities than veterans who had not developed PTSD. The most common physical illnesses that the people with the PTSD experience are locomotor, cardiovascular, endocrine and gastrointestinal. The psychiatric and physical comorbidity among veterans with the PDSD lowers significantly all aspects of the quality of life. The severity of symptoms of the PTSD is not significantly related to the domains of the quality of life, but the length of the therapy is significantly connected to the symptoms of avoidance and numbing within the clinical features of the PTSD, meaning that the veterans with those symptoms have a longer therapy. To the best of our knowledge this is the first research of the connection of the quality of life of the people with the PTSD who have both psychiatric and physical comorbidity in Croatia, and according to the accessible literature, in the world, too