Functional Disability in War Veterans with Post-Traumatic Stress Disorder: A Cross-Sectional WHODAS 2.0 Study at a Saudi Military Hospital

Abstract

Objective: Post-Traumatic Stress Disorder (PTSD) is a major cause of long-term functional disability in war veterans, yet data from Arab and Gulf populations are scarce, and no published study has applied the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to Saudi Arabian war veterans. This study aimed to assess functioning in war veterans with PTSD using the WHODAS 2.0 and to identify clinical and demographic factors associated with functional impairment.

Methods: A cross-sectional study was conducted at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia, involving 40 male war veterans with confirmed “pure” PTSD (no major comorbid psychiatric disorders) diagnosed by a board-certified psychiatrist according to DSM-5 criteria. Participants were enrolled by systematic sampling between 21 December 2023 and 20 March 2024. Demographic and clinical data were obtained through structured interviews and medical-record review, and functioning was assessed using the validated Arabic 36-item WHODAS 2.0. Data were analysed using descriptive statistics, the Mann–Whitney U test, the Kruskal–Wallis H test, and Spearman’s rank correlation; effect sizes (r) are reported alongside p-values.

Results: Participants showed moderate overall disability (median = 42, IQR = 28). The greatest impairment occurred in the Participation in Society domain (median = 51, IQR = 36), followed by Life Activities (median = 48, IQR = 52). Living situation was significantly associated with overall functioning (U = 25.00, Z = −2.56, p = .01; r = 0.40, large), with the small assisted-living subgroup (n = 5) showing greater disability than those living independently (n = 35); given the subgroup imbalance, this finding is exploratory. No significant associations were observed between functioning and marital status, work status, treatment modalities, medication compliance, age, education, or illness duration.

Conclusion: Saudi war veterans with PTSD experience marked functional impairment, particularly in societal participation and life activities. Living situation was the only significant correlate of overall disability. Integrating supported-housing assessment and family-based community reintegration into routine PTSD care may meaningfully reduce functional disability. Larger longitudinal multi-centre Gulf Cooperation Council studies are warranted.