Follow-Up of Child War-Related Post-Traumatic Stress Disorder and Other Psychiatric Disorders in Two Exposed Towns in Cundinamarca, Colombia

OBJECTIVE To determine the evolution of war-related posttraumatic stress disorder (PTSD), other psychiatric disorders, and associated factors,in school-aged children.
METHODS Of 493 school-aged children evaluated initially in two war-exposed towns of Cundinamarca, Colombia, 148 children who werediagnosed with war-related PTSD, anxiety, or depression were invited to participate in a second follow-up assessment. Fifty-five childrenattended and were evaluated with a semi-structured psychiatric interview and the clinician-administered posttraumatic stress scale.
RESULTS PTSD persisted in 50% of the children. Statistical associations were found between persistent PTSD and global child abuse (OR 17.8,95% CI2.73116.8), psychological child abuse (OR16.0, 95% CI 1.7154.6), psychosomatic disorder (OR 6.0, 95% CI1.230.7),simple phobia (OR6.0, 95% CI1.230.7), learning disorder (P.008), major depressive disorder (P.021, Fisher exact test), andhabitual alcohol consumption (P.050, Fisher exact test). Compared with the initial evaluation, this assessment found higher frequenciesof anxiety disorder (73.3% vs 6.7%, McNemar test,PB.001) and child abuse (66.7% vs 20.0%, McNemar test,P.008). Multivariateanalysis found child abuse as predictor of persistent PSTD.
CONCLUSIONS There was a high level of persistent war-related PSTD and child psychopathology. A civil population exposed to war events is at ahigh mental health risk. These children require urgent specialized mental health intervention in order to improve and to reducelong-term persistence of negative effects on their mental health. Child abuse prevention is essential for recovery from childhood PTSD.