Traumatic events, PTSD, and psychiatric comorbidity in forensic patients – assessed by questionnaires and diagnostic interview

Samia Garieballa,Klaus Hoffmann,Evangelia Saleptsi,Maggie Schauer,Frank Neuner,Brigitte S Rockstroh,Tilman Kluttig,Thomas Elbert

doi:10.1186/1745-0179-2-7

Samia Garieballa, Klaus Hoffmann + Show 6 more

Open Access

https://doi.org/10.1186/1745-0179-2-7

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Abstract

BackgroundRelationships between posttraumatic stress disorder (PTSD), comorbid illness and experiences of traumatic stressors have been reported for large and different groups. The present study investigated this relationship specifically for patients with psychiatric disorders admitted to a forensic ward because of criminal behavior.MethodsIn sixteen German and fifteen Sudanese forensic patients the prevalence of PTSD and comorbid symptoms of anxiety and depression were assessed and related to traumatic experiences, emotional distress, and stressful life events over four developmental periods.ResultsIn the total sample, subjects had experienced an average of five traumatic events, the first one occurring early in childhood, and 39% met criteria of current, 55% of lifetime PTSD, the diagnosis being more likely in patients with a greater number of reported traumatic experiences. Neglect and emotional abuse in childhood were associated with current PTSD diagnosis. As reported for other populations, comorbid symptoms were frequent with 60% of the sample displaying comorbid anxiety symptoms and 64% comorbid depression. PTSD and comorbidity did not differ between cultures.ConclusionResults suggest that forensic patients experience multiple traumatic events, usually beginning early in development, so that the assessment of PTSD and comorbid anxiety and depression is recommended for the clinical evaluation. Further studies have to substantiate, whether traumatic stress during developmental stages interact with other factors leading to routes of forensic psychopathology.

Highlights

Relationships between posttraumatic stress disorder (PTSD), comorbid illness and experiences of traumatic stressors have been reported for large and different groups
Traumatic experience and violence might be connected in a vicious circle, in which experience of violence might promote PTSD, and symptoms of PTSD like hyperarousal, the readiness for attack, anger outbursts, flashbacks triggered by conditions similar to those of the traumatic experience, might pose a risk factor for uncontrolled violence and criminal acts [5,6]
Forensic patients in the present study reported exposure to at least one traumatic event serious enough to potentially lead to PTSD

Summary

Introduction

Relationships between posttraumatic stress disorder (PTSD), comorbid illness and experiences of traumatic stressors have been reported for large and different groups. The present study investigated this relationship for patients with psychiatric disorders admitted to a forensic ward because of criminal behavior. Mental illness as a consequence of traumatic experiences, like posttraumatic stress disorder (PTSD), has been reported for large and varied populations [1,2,3,4]. Clinical Practice and Epidemiology in Mental Health 2006, 2:7 http://www.cpementalhealth.com/content/2/1/7 patients are often admitted because of crimes including violence, so that evidence of a relationship between earlier traumatic experience of, for instance, violence and crime, and PTSD might improve our understanding of forensic development. Criminal offenses have been linked to negative or traumatic experiences in childhood, the trauma including the witnessing of interpersonal violence [8], and personality disorders are discussed as mediators between childhood experiences and adult delinquency [13,14,15,16]

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Conclusion