Cottler L B, Nishith P, Compton W M
Department of Psychiatry, Washington University School of Medicine, 40 N Kingshighway, Suite 4, St. Louis, MO 63108, USA.
Compr Psychiatry. 2001 Mar-Apr;42(2):111-7. doi: 10.1053/comp.2001.21219.
Over the past two decades there has been a growing awareness of the comorbidity between post-traumatic stress disorder (PTSD) and substance use disorders in the general population. The purpose of these analyses was to examine, in a population of drug users, the role of gender in (1) predicting the nature of the traumatic event and PTSD symptoms, (2) patterns of substance use disorders in relation to trauma exposure and PTSD symptoms, (3) comorbidity of other psychiatric disorders with trauma exposure and PTSD, and (4) the temporal association of substance use disorder, exposure to trauma, and PTSD. Drug abusers (n = 464) were interviewed using the Diagnostic Interview Schedule for DSM-III-R (DIS) and the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). Although more women than men met criteria for DSM-III-R PTSD, there were no gender differences on endorsement for a traumatic event. Adult antisocial behavior, affective disorder, schizophrenia, other anxiety disorder and polysubstance use predicted exposure to an event, whereas, only schizophrenia and other anxiety disorder predicted PTSD. In men, drug use preceded the exposure to an event, while in women, the onset age for both drug use and exposure to an event were nearly identical. This work suggests implications for gender-based education and prevention interventions.
在过去二十年中，普通人群对创伤后应激障碍（PTSD）与物质使用障碍之间的共病现象的认识日益加深。这些分析的目的是在吸毒人群中研究性别在以下方面的作用：（1）预测创伤事件的性质和PTSD症状；（2）与创伤暴露和PTSD症状相关的物质使用障碍模式；（3）其他精神障碍与创伤暴露和PTSD的共病情况；（4）物质使用障碍、创伤暴露和PTSD的时间关联。使用《精神疾病诊断与统计手册第三版修订本》诊断访谈表（DIS）和《综合国际诊断访谈-物质滥用模块》（CIDI-SAM）对464名吸毒者进行了访谈。尽管符合《精神疾病诊断与统计手册第三版修订本》PTSD标准的女性多于男性，但在创伤事件的认可方面没有性别差异。成人反社会行为、情感障碍、精神分裂症、其他焦虑障碍和多种物质使用可预测经历某一事件，而只有精神分裂症和其他焦虑障碍可预测PTSD。在男性中，吸毒先于经历某一事件，而在女性中，吸毒和经历某一事件的发病年龄几乎相同。这项研究对基于性别的教育和预防干预具有启示意义。
