Maes M, Delmeire L, Mylle J, Altamura C
Clinical Research Center for Mental Health (CRC-MH), Antwerp, Belgium.
J Affect Disord. 2001 Mar;63(1-3):113-21. doi: 10.1016/s0165-0327(00)00173-7.
Previous reports examined the effects of selected pre- (e.g. female gender, previous trauma), peri- (e.g. the horror of the trauma, threatened death) or post-exposure (e.g. the physical injury caused by the trauma) risk factors on the development of post-traumatic stress disorder (PTSD), an anxiety disorder associated with a traumatic event outside the range of usual human experience. We hypothesized that alcohol consumption prior to traumatic events may reduce the incidence rate of PTSD. The aim of this study was to examine the effects of the above risk factors and preventive factors, such as alcohol consumption, on the development of PTSD.
An epidemiological cohort study was carried out on 127 victims trapped in a ballroom fire. Data were collected, 7-9 months after the traumatic event, by means of the Composite International Diagnostic Interview (CIDI) and structured interviews, aimed to assess the above pre-, peri- and post-exposure factors. Logistic regression analysis was used to examine the association of PTSD with the etiologic factors and to delineate those risk factors which contribute most to the development of PTSD.
Female gender, the number of previous trauma, a past history of simple phobia, threatened death, trauma exposure, hospitalization for trauma-induced injuries and the presence of burns increased the odds of PTSD, whereas a sense of control during the trauma, and alcohol consumption and intoxication decreased the odds of PTSD. Six factors made independent contributions to the prediction of PTSD, i.e. the number of previous trauma, a past history of simple phobia, loss of control (increase the odds), a sense of control, alcohol consumption and alcohol intoxication (decrease the odds).
The results of this study show that the development of PTSD is determined by the effects of pre-, peri- and post-exposure risk factors and may be prevented by the effects of peri-traumatic factors, such as sense of control, alcohol consumption and intoxication.
先前的报告研究了某些暴露前（如女性性别、既往创伤）、暴露期间（如创伤的恐怖程度、濒死感）或暴露后（如创伤导致的身体损伤）的危险因素对创伤后应激障碍（PTSD）发生的影响，PTSD是一种与超出正常人类经历范围的创伤事件相关的焦虑障碍。我们假设创伤事件发生前饮酒可能会降低PTSD的发病率。本研究的目的是探讨上述危险因素和预防因素，如饮酒，对PTSD发生的影响。
对127名被困在舞厅火灾中的受害者进行了一项流行病学队列研究。在创伤事件发生7 - 9个月后，通过综合国际诊断访谈（CIDI）和结构化访谈收集数据，旨在评估上述暴露前、暴露期间和暴露后的因素。采用逻辑回归分析来检验PTSD与病因因素之间的关联，并确定那些对PTSD发生贡献最大的危险因素。
女性性别、既往创伤次数、既往单纯恐惧症病史、濒死感、创伤暴露、因创伤性损伤住院以及烧伤的存在增加了患PTSD的几率，而创伤期间的控制感、饮酒和醉酒则降低了患PTSD的几率。六个因素对PTSD的预测有独立贡献，即既往创伤次数、既往单纯恐惧症病史、失去控制（增加几率）、控制感、饮酒和醉酒（降低几率）。
本研究结果表明，PTSD的发生由暴露前、暴露期间和暴露后的危险因素决定，并且可能通过创伤期间的因素，如控制感、饮酒和醉酒来预防。
