Population

PTSD Prevalence

How Measured

When Assessed

Reference

Korean War veterans

Current: 0.25% (n = 401)

Mississippi Scale for Combat-Related PTSD

Combat Exposure Scale

Normative Aging Study cohort; questionnaires sent in 1990

Spiro et al. 1994

World War II veterans

Current: 0.74% (n = 809)

Mississippi Scale for Combat-Related PTSD

Combat Exposure Scale

Normative Aging Study cohort; questionnaires sent in 1990

Spiro et al. 1994

NOTE: CAPS = Clinician-Administered PTSD Scale, CIDI = Composite International Diagnostic Interview, DIS = Diagnostic Interview Schedule, MMPI = Minnesota Multiphasic Personality Inventory, OEF = Operation Enduring Freedom, OIF = Operation Iraqi Freedom, SCID = Structured Clinical Interview for DSM-IV.

In a small study, Bremner et al. (1996) found that of 61 Vietnam veterans with combat-related PTSD, 0 (15%) developed PTSD during their combat tour and 38 (62%) met the criteria for PTSD within 2 years of the end of their combat tour, and 8 patients (13%) did not meet the full criteria for PTSD until 10 or more years after their tours ended. The first symptoms reported were typically in the hyperarousal cluster. Symptoms typically increased during the first few years and then leveled off.

Increasing PTSD symptoms and symptom severity were observed Wolfe et al. (1999) in a larger cohort of 2119 male and 194 female Gulf War veterans screened for PTSD. Five days after their return from the gulf, 3% of the veterans (8% of women and 3% of men) exceeded the PTSD screening cutoff; at 18-24 months, the percentage of veterans exceeding the cutoff had more than doubled to 8% (16% of women and 7% of men).

Similar results were seen in 84 National Guard troops (medical and military police units) returning from the Gulf War (Southwick et al. 1993b, 1995). Most of the PTSD symptoms reported at 2 years after deployment were present by 6 months, but symptom severity continued to increase. The hyperarousal symptom cluster was more prevalent than the intrusive-memories cluster, which was more prevalent than the avoidance-numbing cluster. PTSD symptom severity did not differ between the units or between the sexes. Those who were highly symptomatic at 6 months continued to be symptomatic at 2 years.

In many cases, PTSD will remit naturally (McFarlane 1997). Most (60%) PTSD remissions in the general population occur within 1 year. More than one-third of cases do not remit, however, regardless of whether the person receives treatment (Connor and Butterfield 2003; Kessler et al. 1995). In the NCS, the median time to remission among people who ever sought professional treatment was 36 months, but it was 64 months for those who did not (Kessler et al. 1995). Factors associated with PTSD chronicity in the general population are a greater number of symptoms (especially numbing and arousal symptoms), comorbid alcohol abuse or other psychiatric or medical illness, being female, having a family history of antisocial behavior, and having a history of childhood trauma (Breslau 2001b).

Marshall et al. (2006) found that NVVRS veterans with chronic war-related PTSD had more numbing symptoms and, to a lesser extent, more hyperarousal symptoms than veterans with PTSD in remission; re-experiencing symptoms did not appear to be related to PTSD chronicity.



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