Maes M, Mylle J, Delmeire L, Janca A
Department of Psychiatry, University of Maastricht, Maastricht, The Netherlands.
Psychiatry Res. 2001 Dec 15;105(1-2):1-12. doi: 10.1016/s0165-1781(01)00325-0.
There is evidence suggesting that stressful life events may precede major psychiatric illness, such as major depression, and that the severity of a traumatic event outside the range of usual human experience may provoke post-traumatic stress disorder (PTSD). The present study was carried out to examine the effects of pre- and post-disaster stressful life events on the incidence rate of PTSD following two man-made traumatic events. An epidemiological study examining 127 victims of a flash fire in a ballroom and 55 motor vehicle accident (MVA) victims was undertaken. PTSD symptoms were assessed by means of the Composite International Diagnostic Interview and the pre- and post-disaster stressful life events by means of the Diagnostic Interview Schedule, Disaster Supplement. Binary logistic and multiple linear regression analyses were employed to examine the relationships between PTSD and pre- and post-disaster life events. There were no significant relationships between stressful life events the year prior to the traumatic event and the incidence or severity of PTSD. There were highly significant relationships between the cumulative number and event severity of post-disaster negative life events and the incidence rate and severity of PTSD. The post-disaster life events were significantly more related to the avoidance-depression dimension than to the anxiety-arousal dimension of PTSD. The most significant life events were: loss of job or income, broken relationships, serious illnesses or injuries in the victims and death or illness in close acquaintances. The results of this study show that the number and severity of additional stressful life events signal a higher risk to develop PTSD and a higher severity of the avoidance-depression dimension of PTSD symptomatology.
有证据表明，重大精神疾病（如重度抑郁症）之前可能会出现压力性生活事件，而且超出正常人类经历范围的创伤性事件的严重程度可能会引发创伤后应激障碍（PTSD）。本研究旨在探讨灾难前后压力性生活事件对两起人为创伤事件后PTSD发病率的影响。开展了一项流行病学研究，调查了127名舞厅闪燃事故受害者和55名机动车事故（MVA）受害者。通过综合国际诊断访谈评估PTSD症状，通过诊断访谈表灾难补充版评估灾难前后的压力性生活事件。采用二元逻辑回归和多元线性回归分析来研究PTSD与灾难前后生活事件之间的关系。创伤事件发生前一年的压力性生活事件与PTSD的发病率或严重程度之间没有显著关系。灾难后负面生活事件的累积数量和事件严重程度与PTSD的发病率和严重程度之间存在高度显著的关系。灾难后的生活事件与PTSD的回避-抑郁维度的相关性显著高于与焦虑-唤醒维度的相关性。最显著的生活事件是：失去工作或收入、关系破裂、受害者患重病或受伤以及亲密熟人死亡或患病。本研究结果表明，额外压力性生活事件的数量和严重程度预示着患PTSD的风险更高，以及PTSD症状学回避-抑郁维度的严重程度更高。
