McMillan T M
Department of Psychological Medicine, University of Glasgow, Gartnavel Royal Hospital, UK.
Brain Inj. 2001 Jan;15(1):39-46. doi: 10.1080/02699050118030.
Evidence to support the view that post-traumatic stress disorder (PTSD) can occur after traumatic brain injury (TBI) continues to grow. However, the reported incidence of cases with both diagnoses ranges widely, from less than 1% to more than 50%. Given that the incidence of TBI is high, a more precise incidence has to be established if screening and treatment resources are to be considered. Are cases being missed or are they over-diagnosed? The single case report presented here does not definitively answer this question, but illustrates the potential shortcomings of diagnosing PTSD using questionnaire measures alone (Impact of Events Scale, Post-traumatic Stress Diagnostic Scale and General Health Questionnaire) and indicates a need for a conjoint interview which takes into account the common effects of TBI and the symptom overlap between PTSD and TBI.
支持创伤性脑损伤（TBI）后可发生创伤后应激障碍（PTSD）这一观点的证据不断增加。然而，同时患有这两种诊断的病例报告发病率差异很大，从不到1%到超过50%不等。鉴于TBI的发病率很高，如果要考虑筛查和治疗资源，就必须确定更精确的发病率。是病例被漏诊了还是被过度诊断了？这里呈现的单一病例报告并不能明确回答这个问题，但说明了仅使用问卷测量（事件影响量表、创伤后应激诊断量表和一般健康问卷）来诊断PTSD的潜在缺点，并表明需要进行联合访谈，该访谈要考虑到TBI的常见影响以及PTSD和TBI之间的症状重叠。
