Post-traumatic stress disorder burden among female Syrian war refugees is associated with dysmenorrhea severity but not with the analgesics
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Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, JORDAN
Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, SCOTLAND
Prince Hamza Hospital, Amman, JORDAN
Online publication date: 2023-03-16
Publication date: 2023-07-01
Electron J Gen Med 2023;20(4):em485
Dysmenorrhea association with post-traumatic stress disorder (PTSD) has not been studied in refugees. We aimed to examine the associations between dysmenorrhea severity, dysmenorrhea analgesics self-medications, and PTSD in a cohort of Syrian war refugees residing in Jordan. This is a cross-sectional study based on predetermined inclusion criteria held at Caritas primary care centers in Jordanian districts between September and October 2022. The participants’ demographics and analgesic self-medication type were recorded through a structured questionnaire. The dysmenorrhea severity was measured by (working ability, location, intensity, days of pain, and dysmenorrhea) WaLiDD scale, PTSD was measured by Davidson trauma scale (DTS)-DSM-IV. Data from 347 Syrian female war refugees were analyzed. The multivariate analysis showed that dysmenorrhea severity demonstrated significantly higher estimates for PTSD (10.48 [6.72-14.23], p=0.001), however, the analgesic type was not associated with PTSD burden. In conclusion, dysmenorrhea severity, but not self-medication, was associated with a higher PTSD burden.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5-TR). Washington, DC: American Psychiatric Association; 2013. https://doi.org/10.1176/appi.b....
Qureshi SU, Pyne JM, Magruder KM, Schulz PE, Kunik ME. The link between post-traumatic stress disorder and physical comorbidities: A systematic review. Psychiatr Q. 2009;80(2):87-97. https://doi.org/10.1007/s11126... PMid:19291401.
Gilpin NW, Weiner JL. Neurobiology of comorbid post-traumatic stress disorder and alcohol-use disorder. Genes Brain Behav. 2017;16(1):15-43. https://doi.org/10.1111/gbb.12... PMid:27749004 PMCid:PMC5477640.
Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017;16:1057-72.
Shin G, Lee SJ. Mental health and PTSD in female North Korean refugees. Health Care Women Int. 2015;36(4):409-23. https://doi.org/10.1080/073993... PMid:24020655.
Kim E, Yun M, Jun JY, Park W-S. Pre-migration trauma, repatriation experiences, and PTSD among North Korean refugees. J Immigr Minor Health. 2019;21(3):466-72. https://doi.org/10.1007/s10903... PMid:29651589.
Al-Smadi AM, Tawalbeh LI, Gammoh OS, Ashour AF, Shajrawi A, Attarian H. Relationship between anxiety, post-traumatic stress, insomnia and fibromyalgia among female refugees in jordan: A cross-sectional study. J Psychiatr Ment Health Nurs. 2021;28(4):738-47. https://doi.org/10.1111/jpm.12... PMid:33448096.
Gammouh OS, Al-Smadi AM, Tawalbeh LI, Khoury LS. Chronic diseases, lack of medications, and depression among Syrian refugees in Jordan, 2013-2014. Prev Chronic Dis. 2015;12:E10. https://doi.org/10.5888/pcd12.... PMid:25633485 PMCid:PMC4310712.
Regehr C, Carey M, Wagner S, et al. Prevalence of PTSD, depression and anxiety disorders in correctional officers: A systematic review. Corrections. 2021;6(3):229-41. https://doi.org/10.1080/237746....
Jamil H, Nassar-McMillan SC, Salman WA, Tahar M, Jamil L. Iraqi Gulf War veteran refugees in the U.S.: PTSD and physical symptoms. Soc Work Health Care. 2006;43(4):85-98. https://doi.org/10.1300/J010v4... PMid:16966311.
Arcel LT, Popovic S, Kucukalic A, Bravo-Mehmedbasic A. Treatment of torture and trauma survivors in a post-war society. Sarajevo: Association for Rehabilitation of Torture Victims–Center for Torture Victims; 2003.
Olff M. Sex and gender differences in post-traumatic stress disorder: An update. Eur J Psychotraumatol. 2017;8(sup4):1351204. https://doi.org/10.1080/200081... PMCid:PMC5632782.
Takeda T, Tadakawa M, Koga S, Nagase S, Yaegashi N. Relationship between dysmenorrhea and posttraumatic stress disorder in Japanese high school students 9 months after the Great East Japan Earthquake. J Pediatr Adolesc Gynecol. 2013;26(6):355-7. https://doi.org/10.1016/j.jpag... PMid:24075088.
Tolin DF, Foa EB. Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychol Bull. 2008;132(6):959-92. https://doi.org/10.1037/0033-2... PMid:17073529.
Breslau N. Gender differences in trauma and posttraumatic stress disorder. J Gend Specif Med. 2002;5(1):34-40.
Christiansen DM, Hansen M. Accounting for sex differences in PTSD: A multi-variable mediation model. Eur J Psychotraumatol. 2015;6:26068. https://doi.org/10.3402/ejpt.v... PMid:25604705 PMCid:PMC4300366.
Murthy RS, Lakshminarayana R. Mental health consequences of war: A brief review of research findings. World Psychiatry. 2006;5(1):25-30.
Arcel LT, Kastrup MC. War, women and health. NORA-Nordic J Fem Gend Res. 2004;12(1):40-7. https://doi.org/10.1080/080387....
Kizilhan JI. Trauma and pain in family-orientated societies. Int J Environ Res Public Health. 2018;15(1):44. https://doi.org/10.3390/ijerph... PMid:29283370 PMCid:PMC5800143.
Karstoft K-I, Armour C, Elklit A, Solomon Z. The role of locus of control and coping style in predicting longitudinal PTSD-trajectories after combat exposure. J Anxiety Disord. 2015;32:89-94. https://doi.org/10.1016/j.janx... PMid:25890288.
Gammoh OS, Al-Smadi A, Tayfur M, et al. Syrian female war refugees: Preliminary fibromyalgia and insomnia screening and treatment trends. Int J Psychiatry Clin Pract. 2020;24(4):387-91. https://doi.org/10.1080/136515... PMid:32657625.
Rometsch C, Denkinger JK, Engelhardt M, et al. Pain, somatic complaints, and subjective concepts of illness in traumatized female refugees who experienced extreme violence by the “Islamic State”(IS). J Psychosom Res. 2020;130:109931. https://doi.org/10.1016/j.jpsy... PMid:31981895.
El Sount CR-O, Windthorst P, Denkinger J, et al. Chronic pain in refugees with posttraumatic stress disorder (PTSD): A systematic review on patients’ characteristics and specific interventions. J Psychosom Res. 2019;118:83-97. https://doi.org/10.1016/j.jpsy... PMid:30078503.
Cohen BE, Maguen S, Bertenthal D, Shi Y, Jacoby V, Seal KH. Reproductive and other health outcomes in Iraq and Afghanistan women veterans using VA health care: Association with mental health diagnoses. Women’s Heal Issues. 2012;22(5):e461-71. https://doi.org/10.1016/j.whi.... PMid:22944901 PMCid:PMC4631402.
Bajalan Z, Moafi F, MoradiBaglooei M, Alimoradi Z. Mental health and primary dysmenorrhea: A systematic review. J Psychosom Obstet Gynecol. 2019;40(3):185-94. https://doi.org/10.1080/016748... PMid:29745745.
Szarka A, Rigo JJ, Lazar L, Beko G, Molvarec A. Circulating cytokines, chemokines and adhesion molecules in normal pregnancy and preeclampsia determined by multiplex suspension array. BMC Immunol. 2010;11:59. https://doi.org/10.1186/1471-2... PMid:21126355 PMCid:PMC3014878.
Wu M-H, Lu C-W, Chuang P-C, Tsai S-J. Prostaglandin E2: The master of endometriosis? Exp Biol Med (Maywood). 2010;235(6):668-77. https://doi.org/10.1258/ebm.20... PMid:20511671.
WHO. Guidelines for the regulatory assessment of medicinal products for use in self-medication. World Health Organization; 2000. Available at: https://apps.who.int/iris/hand... (Accessed: 6 February 2023).
Armour M, Parry K, Al-Dabbas MA, et al. Self-care strategies and sources of knowledge on menstruation in 12,526 young women with dysmenorrhea: A systematic review and meta-analysis. PLoS One. 2019;14(7):e0220103. https://doi.org/10.1371/journa... PMid:31339951 PMCid:PMC6655766.
De Sanctis V, Soliman AT, Daar S, et al. Prevalence, attitude and practice of self-medication among adolescents and the paradigm of dysmenorrhea self-care management in different countries. Acta Biomed. 2020;91(1):182-92.
Hawkey AJ, Ussher JM, Perz J, Metusela C. Experiences and constructions of menarche and menstruation among migrant and refugee women. Qual Health Res. 2017;27(10):1473-90. https://doi.org/10.1177/104973... PMid:27742765.
Teherán AA, Piñeros LG, Pulido F, Mejía Guatibonza MC. WaLIDD score, a new tool to diagnose dysmenorrhea and predict medical leave in University students. Int J Womens Health. 2018;10:35-45. https://doi.org/10.2147/IJWH.S... PMid:29398923 PMCid:PMC5775738.
Davidson JRT, Book SW, Colket JT, et al. Assessment of a new self-rating scale for post-traumatic stress disorder. Psychol Med. 1997;27(1):153-60. https://doi.org/10.1017/S00332... PMid:9122295.
Ali M, Farooq N, Bhatti MA, Kuroiwa C. Assessment of prevalence and determinants of posttraumatic stress disorder in survivors of earthquake in Pakistan using Davidson trauma scale. J Affect Disord. 2012;136(3):238-43. https://doi.org/10.1016/j.jad.... PMid:22209270.
Kohler O, Krogh J, Mors O, Benros ME. Inflammation in depression and the potential for anti-inflammatory treatment. Curr Neuropharmacol. 2016;14(7):732-42. https://doi.org/10.2174/157015... PMid:27640518 PMCid:PMC5050394.
Lehrer S, Rheinstein PH. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce suicidal ideation and depression. Discov Med. 2019;28(154):205-12.
Hinz B, Brune K. Paracetamol and cyclooxygenase inhibition: Is there a cause for concern? Ann Rheum Dis. 2012;71(1):20-5. https://doi.org/10.1136/ard.20... PMid:22039164.
Taler M, Gil-Ad I, Lomnitski L, et al. Immunomodulatory effect of selective serotonin reuptake inhibitors (SSRIs) on human T lymphocyte function and gene expression. Eur Neuropsychopharmacol. 2007;17(12):774-80. https://doi.org/10.1016/j.euro... PMid:17499975.
Knights KM, Mangoni AA, Miners JO. Defining the COX inhibitor selectivity of NSAIDs: implications for understanding toxicity. Expert Rev Clin Pharmacol. 2010;3(6):769-76. https://doi.org/10.1586/ecp.10... PMid:22111779.
Müller N, Schwarz MJ, Dehning S, et al. The cyclooxygenase-2 inhibitor celecoxib has therapeutic effects in major depression: Results of a double-blind, randomized, placebo controlled, add-on pilot study to reboxetine. Mol Psychiatry. 2006;11(7):680-4. https://doi.org/10.1038/sj.mp.... PMid:16491133.
Al-Smadi AM, Halaseh HJ, Gammoh OS, Ashour AF, Gharaibeh B, Khoury LS. Do chronic diseases and availability of medications predict post-traumatic stress disorder (PTSD) among Syrian refugees in Jordan? Pak J Nutr. 2016;15(10):936-41. https://doi.org/10.3923/pjn.20....
von Känel R, Hepp U, Kraemer B, et al. Evidence for low-grade systemic proinflammatory activity in patients with posttraumatic stress disorder. J Psychiatr Res. 2007;41(9):744-52. https://doi.org/10.1016/j.jpsy... PMid:16901505.
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