Kessler R C
Department of Health Care Policy, Harvard Medical School, Boston, Mass 02115, USA.
J Clin Psychiatry. 2000;61 Suppl 5:4-12; discussion 13-4.
Little is known about the total population prevalence and societal costs of posttraumatic stress disorder (PTSD); this report reviews relevant literature on these topics.
A literature search of computerized databases for published reports on trauma and PTSD was conducted. This literature was reviewed to find data on general population exposure to trauma, conditional risk of PTSD among those exposed to trauma both in focused samples of trauma victims and in general population samples, and the adverse consequences of PTSD.
PTSD was found to be a commonly occurring disorder that often has a duration of many years and is frequently associated with exposure to multiple traumas. The impairment associated with PTSD in U.S. samples, where the majority of research on these consequences has been carried out, is comparable to, or greater than, that of other seriously impairing mental disorders. Risk of suicide attempts is particularly high among people with PTSD. Available evidence suggests that the prevalence of PTSD and the adverse emotional and psychological consequences of PTSD are much greater in the many countries around the world that are in the midst of armed conflicts involving political, racial, or ethnic violence.
PTSD is a highly prevalent and impairing condition. Only a minority of people with PTSD obtain treatment. Early and aggressive outreach to treat people with PTSD could help reduce the enormous societal costs of this disorder.
关于创伤后应激障碍(PTSD)的总体人群患病率及社会成本,人们了解甚少;本报告回顾了有关这些主题的相关文献。
对计算机化数据库进行文献检索,以查找已发表的关于创伤和PTSD的报告。对这些文献进行回顾,以获取有关普通人群创伤暴露情况、创伤受害者重点样本和普通人群样本中创伤暴露者患PTSD的条件风险以及PTSD不良后果的数据。
发现PTSD是一种常见疾病,通常病程长达数年,且常与多次创伤暴露相关。在美国样本中,与PTSD相关的损害(大部分关于这些后果的研究在此开展)与其他严重损害性精神障碍相当,或更为严重。PTSD患者的自杀未遂风险尤其高。现有证据表明,在世界上许多处于涉及政治、种族或族裔暴力的武装冲突中的国家,PTSD的患病率以及PTSD的不良情绪和心理后果要严重得多。
PTSD是一种高度普遍且具有损害性的疾病。只有少数PTSD患者接受治疗。尽早积极开展针对PTSD患者的治疗工作,有助于降低该疾病带来的巨大社会成本。