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Original Articles
Introduction
Little research has been done on the predictors of the long-term course of post-traumatic stress disorder (PTSD) (reviewed by Steinert et al. 2015). Existing evidence suggests that even though a substantial proportion of cases recover within a few months, at least one-third of cases persist for many years (Kessler et al. 1995; Breslau et al. 1998; Pietrzak et al. 2011; Chapman et al. 2012), and that chronic PTSD can lead to secondary disorders (Perkonigg et al. 2005) and suicidality (Tarrier & Gregg, 2004). The predictors of PTSD recovery considered most often in retrospective research have been trauma type-characteristics, PTSD symptom severity, and history of comorbid mental disorders (Breslau et al. 1998; Pietrzak et al. 2011; Chapman et al. 2012), although systematic reviews of prospective naturalistic studies suggest that socio-demographic factors and childhood adversities might also be important predictors (Steinert et al. 2015).
Previous studies of PTSD recovery were limited in being based on relatively small samples, making it impossible to investigate fine-grained associations. We address this limitation in the current report by presenting data on patterns and predictors of PTSD recovery in a sample of 1575 respondents with a history of PTSD in the WHO World Mental Health (WMH) surveys, a coordinated series of community epidemiological surveys carried out in countries throughout the world (Kessler & Üstün, 2008).
Materials and methods
Samples
Data come from 22 WMH surveys that assessed PTSD due to randomly-selected traumas (defined below). Twelve of these surveys were conducted in countries classified by the World Bank as high-income [Belgium, France, Germany, Israel, Italy, Japan, Netherlands, New Zealand, Northern Ireland, Spain (separate national and regional surveys), the USA], seven in countries classified upper-middle-income (Brazil, Bulgaria, Colombia, Lebanon, Mexico, Romania, South Africa), and three in countries classified low- and lower-middle-income [Peru, Ukraine, Colombia (a national survey administered prior to the previously-mentioned Colombian survey, which was carried out in the Medellin region, when the country income rating was lower)]. Each survey was based on a multi-stage clustered area probability sample of adult household residents. The target population was the entire country in most surveys, all urbanized areas in three (the first Colombian survey in addition to the surveys in Mexico...