A STUDY OF clients at Irish outpatient mental health services in Dublin has found an under-detection of PTSD among psychiatric patients.
The study of trauma and PTSD rates in an Irish psychiatric population involved a comparison of native and immigrant samples.
It was undertaken by Fiona E Wilson, Eilís Hennessy, Dermot A Ryan and Barbara Dooley of the School of Psychology at University College Dublin and Brendan D Kelly of the Department of Adult Psychiatry in the Mater hospital.
They examined and compared rates of traumatic experiences, frequency of traumatic events and rates of PTSD between Irish and migrant service users, including forced migrant and voluntary migrant service-users, a total of 178 psychiatric outpatients, in Dublin.
Their study, which was published in the Disaster Health journal, found that forced migrants displayed more traumatic life events, post-traumatic symptoms and higher levels of PTSD than their voluntary migrant and Irish counterparts, with over 50 per cent experiencing torture prior to their arrival in Ireland.
Trauma
The results of reported traumatic events indicate that the degree of trauma exposure among participants was high.
Overall, 71.3 per cent of service-users had experienced at least one major lifetime traumatic event that would meet the DSM-IV stressor criteria for PTSD.
A significant percentage of both the Irish (67 per cent) and migrant (80 per cent) groups of service-users had experienced at least one traumatic life event.
An overwhelming majority of the forced migrants (93.7 per cent) had experienced a traumatic event, while 65.6 per cent of voluntary migrants had.
The types of trauma differed between both groups: many war or torture-related events were only experienced by forced migrants, such as forced labour, or witness to rape/sexual abuse.
The forced migrant group had significantly higher PTSD scores than the voluntary migrant or Irish groups.
More than half – 53.1 per cent – of forced migrants experienced torture. This was not reported by the other two groups.
The lifetime rate of PTSD in the overall sample was 15.7 per cent, with 2.2 per cent in partial remission and 13.5 per cent with current PTSD.
The lifetime rate of PTSD in the Irish group was 6.1 per cent, while it was 46.9 per cent for forced migrants.
The study “revealed a marked under-reporting of traumatic events in service users’ charts”. While one participant reorted 31 traumatic events to one of the authors, only 14 of them were noted in their chart.
The study said that among the 28 service-users diagnosed with PTSD, only 15 out of the 28 charts listed a diagnosis of PTSD, “suggesting a marked under-detection of PTSD in this sample of adult mental health service-users”.
The authors described this as a “concern”, saying that it is possible that under-detection of trauma and under-diagnosis of PTSD “are the case not only in the outpatient mental health clinics represented in this study but also in services nationwide”.
The full study can be read here.
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