Post-traumatic stress disorder (PTSD). Assessment of its rate of occurrence in the adult population of Portugal

Abstract

This is the first epidemiological study of posttraumatic stress disorder (PTSD) within the adult population (over 18 years of age) in Portugal. This study is particularly relevant given the proportion of the population exposed to trauma: 800,000 men participated in 14 years (from 1961 to 1975) of Portugal's colonial wars. A representative sample of the adult nation-wide population was defined using bi-phasic and stratified methodology. In accordance with study inclusion/exclusion criteria, subjects from all geographical regions were selected, either randomly from the community or via the protocol defined stratification. Subjects identified as having been exposed to one or more traumatic events were further interviewed and assessed with the Short Screening Scale (Breslau, 1999) to determine the presence/absence of DSM-IV defined PTSD. A representative sample of 2,606 subjects (53.3% men) was selected, aged 18 to 99 years old (mean = 43 years). Overall PTSD prevalence rate was 7.87% (205/2,606 subjects) with a statistically significative different distribution by gender: 4.8% for male and 11.4% for female subjects. Around 75% of the Portuguese adult population was exposed to at least one traumatic situation and 43.5% to more than one. We found that 11.6% of the sample were male exposed to combat/war and 9.9% of those developed PTSD. The most referred traumatic situation was Sudden violent death of family or friend, (29.3%), followed by Robed or assaulted, (22.7%) and Witnessing of serious accident or death, (22.2%). The prevalence of posttraumatic stress disorder (overall and by gender) was similar to that reported for other developed countries; lower than expected, given the extent of the population's exposure to combat.