Screening for chronic PTSD after disasters : The gap between self-reported posttraumatic stress and PTSD cases in psychiatric services

• Introduction: Screening disaster survivors for mental health problems after initial recovery may detect unrecognized cases of chronic PTSD. This presentation compares published findings of PTSD prevalence after the 2004 tsunami among exposed Swedish adult survivors.Method: Register data were collected for psychiatric diagnoses made in specialized healthcare for 8762 Swedish adults with various levels of disaster exposure. Posttraumatic stress (PTS) was assessed and exposure established for 2268 individuals who filled out the Impact of Event Scale–Revised (IES-R) in surveys at 1, 3, and 6 years post-disaster. A subset of directly exposed participants (n=142) were assessed for current and post-disaster PTSD with SCID interviews.Results: In the survey sample, 5% of participants reported very high and 11% reported high levels of PTS across all surveys. The post-disaster prevalence of PTSD was 11.3% in the interview sample. In healthcare services, the 5-year incidence was 0.5% for PTSD and 2.1% for any stress-related disorder. Findings suggested that the IES-R possessed good screening properties, e.g., sensitivity ≥ 0.92.Discussion: These studies indicate large differences between the PTS load among survivors and the number of PTSD cases in healthcare services, making a case for individual symptom screening. Yet, screening for chronic PTSD with current methods will yield a substantial numbers of incorrectly classified survivors (640 false positives in this sample), providing challenges to psychosocial follow-up services.Part of symposium: Screening for mental health after trauma in children and adults: importance, instruments, & innovations

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MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

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