Family Practice Vol. 20, No. 4, 489-491
© Oxford University Press 2003
International Health Care Research |
Post-traumatic stress disorder among family physicians in Bosnia and Herzegovina
d
a Department of Family Medicine,
b Queen’s University Family Medicine Development Program in the Balkans Region,
c Centre for Studies in Primary Care, Queen’s University, Kingston, Ontario, Canada and
d Department of Psychiatry, University of Tuzla, Bosnia and Herzegovina.
Correspondence to Ms Teresa Broers, Family Medicine Centre, 220 Bagot Street, PO Bag 8888, Kingston, Ontario, Canada; E-mail: broerst{at}post.queensu.ca
Background. The traumatic events experienced by thousands of people in Bosnia and Herzegovina during the 1992–1995 conflict may have a lasting effect on the mental health of the country, characterized by high rates of post-traumatic stress disorder (PTSD). A diagnosis of PTSD among family physicians could affect their ability to diagnose and treat patients for depression, anxiety and PTSD.
Objective. The aim of the present study was to determine the prevalence of PTSD among family medicine physicians in Bosnia and Herzegovina.
Methods. A self-administered questionnaire, including the PTSD Checklist–Civilian Version (PCL-C) which is a validated scale for PTSD screening, was distributed to family medicine residents and specialists in Bosnia and Herzegovina. The prevalence of PTSD was determined, and factors related to PTSD were considered.
Results. One hundred and thirty-three (90.5%) of the 147 physicians who were available to be surveyed completed the questionnaire. Of the 88% who had a traumatic experience during the war, 18% met the criteria for PTSD. The likelihood of meeting the criteria for PTSD was not affected by age, sex or whether the physician had worked in a field hospital during the war. However, a positive response to the question "Do you think the traumatic event you experienced during the war still affects you today?" was highly associated with the diagnosis of PTSD (odds ratio 7.26, 95% confidence interval: 1.57–33.60). Also, this question was shown to have a high degree of sensitivity and negative predictive value, and may be of use as a screening tool for ruling out the presence of PTSD after a traumatic war experience.
Keywords. Bosnia and Herzegovina, epidemiology, family medicine, post-traumatic stress disorder.