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Mental health of internally displaced persons in Ukraine
P.4.f. Anxiety disorders, OCD, stress related disorders and treatment − Other (clinical) P.4.f.013 Mental health of internally displaced persons in Ukraine
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of mental disorders (gender, age, influence of stressors); study of access to and use of medical services and services of psychosocial support, their effectiveness.
V. Korostiy1 ° 1 Kharkiv National Medical University, Psychiatrynarcology and medical psychology, Kharkiv, Ukraine According to the data of the international organization Internal Displacement Monitoring Centre today over 38.2 million of IDP are registered in the world. Over 1.5 million of them are Ukrainians who were forced to leave their home after Crimea annexation and military conflict in the East of Ukraine. Among the countries with the highest numbers of IDP Ukraine is on the 8th place in the world (2.45% of IDPs out of a total number of population). The number of publication in international peer-reviewed journals show that among displaced persons mental disorders can be found more frequently than in the other population, which influence their ability for social adaptation. Aims of the study: 1. screening of IDPs at the moment of their arrival to Kharkiv. 2. study of mental health of those IDPs who asked for psychological or psychiatric help. 3. screening of IDPs’ mental health who sought medical help in somatic clinic (University clinic KhNMU). 4. consultations with specialists and volunteers who have experience in consulting IDPs. Methods: Mississippi Scale for Civilian PTSD, HADS, HARS, HDRS. Results: Mental disorders on IDPS in Kharkiv region in acute “after-flying” period (n = 360, 2014): Acute stress reactions 75.9%, Anxiety disorders 13.3%, Long-term depressive reaction 3.3%, PTSD 8.6%. Mental disorders on IDPS in Kharkiv region in out-patient or In-patient psychiatric care (n = 112, 2014–2015): Acute stress reactions 6.5%, Anxiety disorders 32.8%, Long-term depressive reaction 53.3%, PTSD 23.6%. Mental disorders on replacement persons from DonetskLugansk region with somatic disorders in general hospital (University clinic (n = 128, 2015): Acute stress reactions 0, Anxiety disorders 56.2%, Long-term depressive reaction 32.0%, PTSD 10.3%. Replacement persons from Donetsk-Lugansk region in the general hospital. During 2015, 128 people displaced from Luhansk and Donetsk regions addressed for medical help to the University Clinic of Kharkiv National Medical University. Reasons for their visit in all cases were somatic complains. During screening with the use of hospital scale in all patients heightened indexes of anxiety and depression were found. 80% of patients had psychosomatic disorders. Conducting the complex of physical rehabilitation (kinesiotherapy, physical exercises, TRE) for 14 days provided decline of anxiety to the physiological level in all mentally healthy patients, reduction of psychosomatic symptoms. Conclusions: Trauma-focused interventions include exposition and a cognitive re-structurization. Refugees (internally displaced persons) are managed in their new locations in civilian public health institutions (psychosomatic departments of general hospitals, department of neuroses of psychoneurological hospitals). The matter of a great importance for rehabilitation is a social support, solving problems of these persons’ accommodation, employment, education and care for their children, etc. The aim of future study should be to define the epidemiology of mental disorders, namely PTSD, depressions, psychoactive drugs abuse; study of demographic and socio-economic characteristics
P.4.f.014 A comparison of the Korean version of posttraumatic diagnostic scale and clinician administered PTSD scale assessment for PTSD in Korean veterans H.S. So1 ° , J. Choi1 , H. Chung1 , T. Kim1 , S. Kang1 1 Seoul Veterans Hospital, Dept. of Psychiatry, Seoul, South-Korea Background: Clinician Administered PTSD Scale (CAPS) is well known as the gold-standard instrument for the diagnosis of Posttraumatic stress disorder (PTSD), but administration of the CAPS should be done by a trained mental health professionals and requires relatively longer time to perform. Posttraumatic Diagnostic Scale (PDS) [1] was known as useful self-report instrument for the diagnosis of PTSD in both general psychiatry outpatients setting [2] and domestic violence victims [3]. The optimal cutoff score for identifying PTSD cases with the PDS was 27 in general psychiatry outpatients, and 17 in domestic violence victims. But PDS was not evaluated for the diagnosis of PTSD in Korean veterans population. The aim of the study was to compare PDS and CAPS for diagnosing PTSD in Korean veteran patients. Methods: 77 patients who referred to outpatient PTSD clinic took the K-PDS [4] first and then took the CAPS by the trained clinicians who were blind to the PDS score. F1/I2 scoring rule [5] was used for the diagnosis of PTSD by the CAPS interview. The CAPS and PDS total scores and subscale scores between PTSD group and non-PTSD group were compared by Mann Whitney U test. Spearman correlations were calculated between the total scale score and each subscale score for all participants. The receiver operation characteristic (ROC) analysis was conducted to examine the utility of the PDS compared to the CAPS, then the efficiency of the PDS were calculated. Results: 23 of 77 patients (29.9%) diagnosed with PTSD by the analysis of the CAPS interview. 17 of 23 patients (73.9%) experienced war related trauma when they were served in Vietnam War. Mean CAPS scores between the PTSD group and non-PTSD group were significantly different (65.6±17.3 vs. 21.4±14.8, p < 0.001) and mean PDS scores of the two groups were also significantly different (36.4±8.6 vs. 20.8±14.2, p < 0.001). The ROC curve analysis showed that the diagnostic utility of the PDS was significantly better than chance, with the area under the curve equal to 0.812 (p < 0.001). Using PDS cutoff 25, the sensitivity was 91.3% and the specificity was 64.8% which shows 35.2% false-positive rate and 8.7% false negative rate. PDS total score (Spearman’s rho = 0.578, p < 0.001), PDS reexperience subscore (Spearman’s rho = 0.460, p < 0.001), PDS avoidance subscore (Spearman’s rho = 0.553), PDS hyperarousal subscore (Spearman’s rho = 0.448, p < 0.448) showed significant correlation with each corresponding CAPS scores. Conclusions: The PDS showed very high sensitivity but relatively poor specificity for the diagnosis of PTSD in Korean veterans. These findings suggest that in the clinical sample of Korean veterans, the PDS tended to provide close agreement with the CAPS diagnosis of PTSD, and it suggests that the PDS relatively performed well as a possible alternative for the full CAPS interview. Small PTSD group sample size is the limitation of this study.
S633
of mental disorders (gender, age, influence of stressors); study of access to and use of medical services and services of psychosocial support, their effectiveness.
V. Korostiy1 ° 1 Kharkiv National Medical University, Psychiatrynarcology and medical psychology, Kharkiv, Ukraine According to the data of the international organization Internal Displacement Monitoring Centre today over 38.2 million of IDP are registered in the world. Over 1.5 million of them are Ukrainians who were forced to leave their home after Crimea annexation and military conflict in the East of Ukraine. Among the countries with the highest numbers of IDP Ukraine is on the 8th place in the world (2.45% of IDPs out of a total number of population). The number of publication in international peer-reviewed journals show that among displaced persons mental disorders can be found more frequently than in the other population, which influence their ability for social adaptation. Aims of the study: 1. screening of IDPs at the moment of their arrival to Kharkiv. 2. study of mental health of those IDPs who asked for psychological or psychiatric help. 3. screening of IDPs’ mental health who sought medical help in somatic clinic (University clinic KhNMU). 4. consultations with specialists and volunteers who have experience in consulting IDPs. Methods: Mississippi Scale for Civilian PTSD, HADS, HARS, HDRS. Results: Mental disorders on IDPS in Kharkiv region in acute “after-flying” period (n = 360, 2014): Acute stress reactions 75.9%, Anxiety disorders 13.3%, Long-term depressive reaction 3.3%, PTSD 8.6%. Mental disorders on IDPS in Kharkiv region in out-patient or In-patient psychiatric care (n = 112, 2014–2015): Acute stress reactions 6.5%, Anxiety disorders 32.8%, Long-term depressive reaction 53.3%, PTSD 23.6%. Mental disorders on replacement persons from DonetskLugansk region with somatic disorders in general hospital (University clinic (n = 128, 2015): Acute stress reactions 0, Anxiety disorders 56.2%, Long-term depressive reaction 32.0%, PTSD 10.3%. Replacement persons from Donetsk-Lugansk region in the general hospital. During 2015, 128 people displaced from Luhansk and Donetsk regions addressed for medical help to the University Clinic of Kharkiv National Medical University. Reasons for their visit in all cases were somatic complains. During screening with the use of hospital scale in all patients heightened indexes of anxiety and depression were found. 80% of patients had psychosomatic disorders. Conducting the complex of physical rehabilitation (kinesiotherapy, physical exercises, TRE) for 14 days provided decline of anxiety to the physiological level in all mentally healthy patients, reduction of psychosomatic symptoms. Conclusions: Trauma-focused interventions include exposition and a cognitive re-structurization. Refugees (internally displaced persons) are managed in their new locations in civilian public health institutions (psychosomatic departments of general hospitals, department of neuroses of psychoneurological hospitals). The matter of a great importance for rehabilitation is a social support, solving problems of these persons’ accommodation, employment, education and care for their children, etc. The aim of future study should be to define the epidemiology of mental disorders, namely PTSD, depressions, psychoactive drugs abuse; study of demographic and socio-economic characteristics
P.4.f.014 A comparison of the Korean version of posttraumatic diagnostic scale and clinician administered PTSD scale assessment for PTSD in Korean veterans H.S. So1 ° , J. Choi1 , H. Chung1 , T. Kim1 , S. Kang1 1 Seoul Veterans Hospital, Dept. of Psychiatry, Seoul, South-Korea Background: Clinician Administered PTSD Scale (CAPS) is well known as the gold-standard instrument for the diagnosis of Posttraumatic stress disorder (PTSD), but administration of the CAPS should be done by a trained mental health professionals and requires relatively longer time to perform. Posttraumatic Diagnostic Scale (PDS) [1] was known as useful self-report instrument for the diagnosis of PTSD in both general psychiatry outpatients setting [2] and domestic violence victims [3]. The optimal cutoff score for identifying PTSD cases with the PDS was 27 in general psychiatry outpatients, and 17 in domestic violence victims. But PDS was not evaluated for the diagnosis of PTSD in Korean veterans population. The aim of the study was to compare PDS and CAPS for diagnosing PTSD in Korean veteran patients. Methods: 77 patients who referred to outpatient PTSD clinic took the K-PDS [4] first and then took the CAPS by the trained clinicians who were blind to the PDS score. F1/I2 scoring rule [5] was used for the diagnosis of PTSD by the CAPS interview. The CAPS and PDS total scores and subscale scores between PTSD group and non-PTSD group were compared by Mann Whitney U test. Spearman correlations were calculated between the total scale score and each subscale score for all participants. The receiver operation characteristic (ROC) analysis was conducted to examine the utility of the PDS compared to the CAPS, then the efficiency of the PDS were calculated. Results: 23 of 77 patients (29.9%) diagnosed with PTSD by the analysis of the CAPS interview. 17 of 23 patients (73.9%) experienced war related trauma when they were served in Vietnam War. Mean CAPS scores between the PTSD group and non-PTSD group were significantly different (65.6±17.3 vs. 21.4±14.8, p < 0.001) and mean PDS scores of the two groups were also significantly different (36.4±8.6 vs. 20.8±14.2, p < 0.001). The ROC curve analysis showed that the diagnostic utility of the PDS was significantly better than chance, with the area under the curve equal to 0.812 (p < 0.001). Using PDS cutoff 25, the sensitivity was 91.3% and the specificity was 64.8% which shows 35.2% false-positive rate and 8.7% false negative rate. PDS total score (Spearman’s rho = 0.578, p < 0.001), PDS reexperience subscore (Spearman’s rho = 0.460, p < 0.001), PDS avoidance subscore (Spearman’s rho = 0.553), PDS hyperarousal subscore (Spearman’s rho = 0.448, p < 0.448) showed significant correlation with each corresponding CAPS scores. Conclusions: The PDS showed very high sensitivity but relatively poor specificity for the diagnosis of PTSD in Korean veterans. These findings suggest that in the clinical sample of Korean veterans, the PDS tended to provide close agreement with the CAPS diagnosis of PTSD, and it suggests that the PDS relatively performed well as a possible alternative for the full CAPS interview. Small PTSD group sample size is the limitation of this study.