Twelve-year follow-up study of Khmer youths who suffered massive war trauma as children

Abstract

Objective: Twenty-seven of 40 Khmer adolescent youths who had survived the horrors of the Pol Pot regime (1975-1979) as children and 4 of 6 who had escaped this war were reinterviewed for the fourth time, during the summer of 1996, to determine their diagnostic status for posttraumatic stress disorder (PTSD) and/or depression and their functional status with regard to occupational and/or educational pursuits. They had been interviewed initially in 1983-1984 and again 3 (1987) and 6 (1990-1991) years later.

Method: PTSD was determined using the Diagnostic Interview for Children and Adolescents, and depression was assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children.

Results: The point prevalence rates of PTSD were comparable with those found 6 years earlier, and rates of depression were much lower but had increased somewhat over the ensuing 6 years. The onset of PTSD was quite variable, with 18% of subjects (7/40) developing PTSD at least 5 years after cessation of the Pol Pot hostilities. Subjects with PTSD were more likely to recall specifically traumatic war memories, whereas those without PTSD were more likely to recall memories of loss and/or displacement. Most subjects were functioning well, regardless of diagnostic status.

Conclusions: Although its onset is quite variable, PTSD persists in war-traumatized Cambodian refugee youths. PTSD and depression appear to follow different pathways over time. PTSD need not be associated with major functional impairment.