Ursano R J, Fullerton C S, Epstein R S, Crowley B, Kao T C, Vance K, Craig K J, Dougall A L, Baum A
Department of Psychiatry, Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Bethesda, MD 20814-4799, USA.
Am J Psychiatry. 1999 Apr;156(4):589-95. doi: 10.1176/ajp.156.4.589.
This study reports the rates of acute and chronic posttraumatic stress disorder (PTSD) in a suburban community study group of 122 victims of serious motor vehicle accidents and a comparison group of 42 (who had been involved in minor, non-motor-vehicle accidents) followed over 12 months.
Motor vehicle accident victims were systematically recruited and examined with comparison subjects at 1, 3, 6, 9, and 12 months after the accident. The authors used the Structured Clinical Interview for DSM-III-R to assess DSM-III-R axis I disorders including PTSD.
One month after the accident, 34.4% of the motor vehicle accident victims met criteria for PTSD (versus 2.4% of the comparison subjects). Similarly, at 3 and 6 months, rates of PTSD were higher (25.2% and 18.2%) in the motor vehicle accident victims than in the comparison group. Female victims were 4.64 times more likely than male victims to have PTSD at 1 month. Victims with a history of PTSD were 8.02 times more likely at 1 month and 6.81 times more likely at 3 months to have PTSD than those without a history of PTSD. Having an axis II disorder increased the risk for PTSD at 6 months. After adjustment for a history of PTSD and potentially confounding variables, women were 4.39 times more likely than men to develop PTSD at 1 month but did not have a higher risk for chronic PTSD; at 6 months, those with an axis II disorder were at greater risk of PTSD.
Rates of PTSD are high in victims of serious motor vehicle accidents and remain high 9 months later. Female victims have an increased risk of acute but not chronic PTSD. Individuals with a history of PTSD are at risk of acute and chronic PTSD. An axis II disorder increases the risk for chronic but not acute PTSD.
本研究报告了一个郊区社区研究组中122名严重机动车事故受害者以及一个由42名（曾遭遇轻微非机动车事故）组成的对照组在12个月内的急性和慢性创伤后应激障碍（PTSD）发生率。
系统招募机动车事故受害者，并在事故发生后的1、3、6、9和12个月与对照对象进行检查。作者使用《DSM-III-R结构化临床访谈》来评估包括PTSD在内的DSM-III-R轴I障碍。
事故发生1个月后，34.4%的机动车事故受害者符合PTSD标准（对照组为2.4%）。同样，在3个月和6个月时，机动车事故受害者的PTSD发生率高于对照组（分别为25.2%和18.2%）。女性受害者在1个月时患PTSD的可能性是男性受害者的4.64倍。有PTSD病史的受害者在1个月时患PTSD的可能性是无PTSD病史者的8.02倍，在3个月时是6.81倍。患有轴II障碍会增加6个月时患PTSD的风险。在对PTSD病史和潜在混杂变量进行调整后，女性在1个月时患PTSD的可能性是男性的4.39倍，但慢性PTSD风险并未更高；在6个月时，患有轴II障碍者患PTSD的风险更大。
严重机动车事故受害者的PTSD发生率很高，9个月后仍居高不下。女性受害者急性PTSD风险增加，但慢性PTSD风险未增加。有PTSD病史的个体有急性和慢性PTSD风险。轴II障碍会增加慢性PTSD风险，但不会增加急性PTSD风险。
