<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Hashemian, Farnoosh</style></author><author><style face="normal" font="default" size="100%">Khoshnood, Kaveh</style></author><author><style face="normal" font="default" size="100%">Desai, Mayur M</style></author><author><style face="normal" font="default" size="100%">Falahati, Farahnaz</style></author><author><style face="normal" font="default" size="100%">Kasl, Stanislav</style></author><author><style face="normal" font="default" size="100%">Southwick, Steven</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Anxiety, depression, and posttraumatic stress in Iranian survivors of chemical warfare.</style></title><secondary-title><style face="normal" font="default" size="100%">JAMA</style></secondary-title><alt-title><style face="normal" font="default" size="100%">JAMA</style></alt-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Anxiety</style></keyword><keyword><style  face="normal" font="default" size="100%">Chemical Warfare</style></keyword><keyword><style  face="normal" font="default" size="100%">Comorbidity</style></keyword><keyword><style  face="normal" font="default" size="100%">Cross-Sectional Studies</style></keyword><keyword><style  face="normal" font="default" size="100%">Depression</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Iran</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Mental Health</style></keyword><keyword><style  face="normal" font="default" size="100%">Middle Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Population Surveillance</style></keyword><keyword><style  face="normal" font="default" size="100%">Stress Disorders, Post-Traumatic</style></keyword><keyword><style  face="normal" font="default" size="100%">Survival</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2006</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2006 Aug 2</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">296</style></volume><pages><style face="normal" font="default" size="100%">560-6</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;CONTEXT: In the 1980-1988 Iran-Iraq War, extensive use of chemical weapons resulted in high rates of morbidity and mortality. While much is known about the physical consequences of chemical warfare, there is a paucity of information about the long-term effects of chemical attacks on mental health.&lt;/p&gt;
&lt;p&gt;OBJECTIVE: To assess the long-term psychological impact of chemical warfare on a civilian population.&lt;/p&gt;
&lt;p&gt;DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional randomized survey conducted in July 2004 of 153 civilians in 3 towns exposed to warfare in northwestern Iran: Oshnaviyeh (low-intensity conventional warfare), Rabat (high-intensity conventional warfare), and Sardasht (both high-intensity conventional warfare and chemical weapons).&lt;/p&gt;
&lt;p&gt;MAIN OUTCOME MEASURES: Full or partial posttraumatic stress disorder (PTSD) diagnosis, anxiety symptoms, and depressive symptoms were assessed using Farsi versions of the Clinician-Administered PTSD Scale, Hamilton Scale for Anxiety, and Beck Depression Inventory, respectively.&lt;/p&gt;
&lt;p&gt;RESULTS: Overall participation rate was 93%. Respondents had a mean age of 45 years and were all of Kurdish ethnicity. Among individuals exposed to both high-intensity warfare and chemical weapons, prevalence rates for lifetime PTSD, current PTSD, major anxiety symptoms, and severe depressive symptoms were 59%, 33%, 65%, and 41%, respectively. Among the low-intensity warfare group, the corresponding rates were 8%, 2%, 18%, and 6%, respectively, while intermediate rates were found among those exposed to high-intensity warfare but not to chemical weapons (31%, 8%, 26%, and 12%, respectively). Compared with individuals exposed to low-intensity warfare, those exposed to both high-intensity warfare and chemical weapons were at higher risk for lifetime PTSD (odds ratio [OR], 18.6; 95% confidence interval [CI], 5.8-59.4), current PTSD (OR, 27.4; 95% CI, 3.4-218.2), increased anxiety symptoms (OR, 14.6; 95% CI, 6.0-35.6), and increased depressive symptoms (OR, 7.2; 95% CI, 3.3-15.9). Exposure to high-intensity warfare but not to chemical weapons was also significantly associated with lifetime PTSD (OR, 5.4; 95% CI, 1.7-17.6), compared with those in the low-intensity warfare group. Further, compared with individuals exposed to high-intensity warfare alone, those exposed to both high-intensity warfare and chemical weapons were at higher risk for lifetime PTSD (OR, 3.4; 95% CI, 1.5-7.4), current PTSD (OR, 6.2; 95% CI, 2.0-20.1), increased anxiety symptoms (OR, 5.6; 95% CI, 2.5-12.6), and increased depressive symptoms (OR, 3.7; 95% CI, 1.8-7.2).&lt;/p&gt;
&lt;p&gt;CONCLUSION: Exposure to chemical warfare is an extreme traumatic event that has long-lasting adverse consequences on mental health.&lt;/p&gt;
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