Health-Related Quality of Life of Ex-Prisoners of War Affected by Posttraumatic Stress Disorder 25 Years After Captivity.

BACKGROUND: War captivity is one of the most difficult human experiences and can cause long-lasting effects on mental and physical health. Posttraumatic Stress Disorder (PTSD), as one of the frequent consequences of war trauma, is often associated with the psychiatric and/or somatic comorbidity. Therefore, PTSD results in impaired Health-Related Quality of Life (HRQoL). This study aimed to investigate the HRQoL in the Croatian Homeland War ex-POWs affected by PTSD, regarding the intensity of PTSD symptoms, sociodemographic characteristics and somatic comorbidity, and to identify predictors of poor HRQoL.

SUBJECTS AND METHODS: The study sample consisted of two groups (45 participants each) based on whether they were POWs or not (control group). All study participants were diagnosed with PTSD according to the ICD-10 criteria and had combat experience as active participants in defence of the Republic of Croatia during the Homeland War. The subjects were evaluated using the sociodemographic questionnaire, PTSD self-report checklist (PCL-5) and Short Form (SF-36) Health Survey questionnaire. The data on participants' physical diseases were collected from medical anamnesis and medical records in the last five years.

RESULTS: In relation to ex-POWs, the control group had significantly smaller number of retirees, more unemployed persons, smaller number of married subjects, and higher number of divorced persons. Low socioeconomic status and intensity of PTSD symptoms has been confirmed as a significant predictor of impaired HRQoL in both subject groups. The most commonly PTSD associated physical diseases were musculosceletal, cardiovascular, and gastrointestinal diseases. Endocrine and metabolic diseases were more frequent in the ex-POWs' group.

CONCLUSIONS: PTSD was associated with the HRQoL, whether the veterans were ex-POWs or not. The hypothesis that exposure of ex-POWs to the trauma of captivity experience impaired HRQoL to a greater extent, compared to the non-detained veterans, was not confirmed. Low socioeconomic status has proved to be the most significant predictor of poorer HRQoL.