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Global Refugees Checklist
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Overview of Post-Traumatic Stress Disorder (PTSD)

45% of Canadian immigrants and refugees from countries involved in war or with significant social unrest have been exposed to traumatic events before migration. Most individuals (estimated 80%) who experience traumatic events heal without intervention after reaching safety:

Key Recommendations:

Quality of Evidence: LOW

Balance of benefits and harms Values and preferences
  • Many persons who have been exposed to trauma do fine once they find safety and social supports.
  • Brief screening instruments overestimate the rate of disease because they focus on symptoms and do not measure functional impairment.
  • Detailed inquiry and pushing for disclosure without indications of distress or disorder could be harmful.
  • There are no clinical trials demonstrating the benefits of routine screening for PTSD.

The committee:

  • Determined that PTSD was best dealt with through primary care practitioners remaining alert for signs and symptoms of this condition and performing clinical assessment to address functional impairment

Attributed more value to:

  • Preventing potential harms from routine screening in the absence of clear evidence of benefits

Links to Other Learning Resources

Pottie K, Greenaway C, Feightner J, Welch V, Swinkels H, Rashid M, Narasiah L, Kirmayer L, Ueffing E, MacDonald N, Hassan G, McNally M, Kahn K, Buhrmann R, Dunn S, Dominic A, McCarthy AE, Gagnon AJ, Rousseau C, Tugwell P and co-authors of the Canadian Collaboration for Immigrant and Refugee Health. Overview: Evidence-based clinical guidelines for immigrants and refugees. CMAJ 2011; 183(12):E824-E925.

Design and Production: Centre for e-Learning, Teaching and Learning Support Service (TLSS), University of Ottawa