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

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 es caped this war were reinterviewed for the fourth time, during the summer of 1996, to determine their diagnostic status for posttraumatic stress disord er (PTSD) and/or depression and their functional status with regard to occu pational and/or educational pursuits. They had been interviewed initially i n 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 dep ression 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) develop ing PTSD at least 5 years after cessation of the Pol Pot hostilities. Subje cts with PTSD were more likely to recall specifically traumatic war memorie s, whereas those without PTSD were more likely to recall memories of loss a nd/or displacement. Most subjects were functioning well, regardless of diag nostic status. Conclusions: Although its onset is quite variable, PTSD pers ists in war-traumatized Cambodian refugee youths. PTSD and depression appea r to follow different pathways over time. PTSD need not be associated with major functional impairment.