Bosnian Refugees' PTSD Rates 25 Times Higher Than Swedes'

January 12, 1999

Everyone knows war is stressful, and civil war perhaps most stressful of all, but now Swedish scientists have documented just how traumatically stressful it can be.

Two researchers screened 206 Bosnian refugees for symptoms of post-traumatic stress disorder (PTSD) and found that an estimated 18 to 33 percent of them suffered from the disorder. This is 25 to 68 times the prevalence they found in a comparison group of Swedish subjects given the same screening.

The study was conducted by Hans Thulesius, MD, and Anders Håkansson, M.D., Ph.D., of Lund University at Malmö, Sweden, in March and April 1993, while the Bosnian civil war was widespread. Their results are reported in the January issue of the Journal of Traumatic Stress.

Sweden received large numbers of Bosnian refugees during the war. By 1997, the refugees numbered about 80,000. Refugees arriving at the asylum center in Sweden reported hideous atrocities they had experienced: a soldier said he had seen a baby nailed to a barn with a pitchfork; a woman told of seeing her father being decapitated; and a man said he had witnessed his wife being raped.

Other reported traumas included combat experience, missing family members, death threats, and sexual abuse. The prison camps where some of the refugees had been held at starvation levels were "reminiscent...of Nazi concentration camps," according to the researchers.

PTSD symptoms were measured by asking both refugees and controls to rate on a scale of one to seven the extent to which they had experienced the following symptoms during the preceding week: problems with sleeping, nightmares about their trauma, depression, startle reactions, tendency to be isolated from others, irritability, emotional ability, guilt or self-blame, fears of places or situations that resembled the traumatic event, and bodily tension. The questionnaire was translated into Serbo-Croatian for the Bosnians.

In the comparison group of 387 Swedish visitors to seven health centers, the PTSD screening showed that an estimated 0.3 to 1.3 percent potentially had the disorder, even though 14 percent of them (55 persons) reported experiencing traumatic events, including accidents, rape and other violent crimes, and war experiences.

The Swedish study confirms what a smaller American study found in 1995, when 13 of 20 Bosnian refugees were diagnosed with PTSD.
The Journal of Traumatic Stress is the peer-reviewed journal of the International Society of Traumatic Stress Studies. For information about the society and the journal, contact the editor, Dean Kilpatrick, Ph.D., 843-792-2945.

Posted by the Center for the Advancement of Health For information about the Center, contact Richard Hebert 202-387-2829.

Center for Advancing Health

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