Koren D, Arnon I, Klein E
Department of Psychiatry, Rambam Medical Center, B. Rappaport Faculty of Medicine Technion I.I.T., Haifa, Israel.
Behav Res Ther. 2001 Dec;39(12):1449-58. doi: 10.1016/s0005-7967(01)00025-0.
The purpose of the present study was to gather prospective longitudinal data on the long-term course and outcome of chronic posttraumatic stress disorder (PTSD). The target population for this study was 74 injured traffic accident victims who had been previously followed-up for one year after the trauma. Nineteen of the original 24 PTSD subjects (79%) and 39 of the original 50 Non-PTSD subjects (78%) were available for this study, which took place during the fourth year after the accident. Our results show that 10 (53%) of the 19 patients with PTSD at one-year still suffered from PTSD after another two-year follow-up interval, while 9 recovered from PTSD during this follow-up period. Only 2 of the 39 without PTSD at one year developed delayed onset PTSD. The best predictor of recovery from chronic PTSD was the initial level of posttraumatic reaction immediately after the accident. These results demonstrate that spontaneous recovery from PTSD can occur even among patients who are currently considered chronic. Severity of initial reaction to the trauma appears to be a major risk factor for non-remitting chronic PTSD.
本研究的目的是收集关于慢性创伤后应激障碍（PTSD）长期病程和结局的前瞻性纵向数据。本研究的目标人群是74名交通事故受伤受害者，他们在创伤后曾接受过一年的随访。最初的24名PTSD受试者中有19名（79%），最初的50名非PTSD受试者中有39名（78%）可用于本研究，该研究在事故发生后的第四年进行。我们的结果显示，在一年时患有PTSD的19名患者中，有10名（53%）在又经过两年的随访期后仍患有PTSD，而9名在此随访期内从PTSD中康复。在一年时无PTSD的39名患者中，只有2名出现了延迟性PTSD。慢性PTSD康复的最佳预测指标是事故后即刻的创伤后反应初始水平。这些结果表明，即使在目前被认为是慢性PTSD的患者中，也可能出现自发康复。创伤初始反应的严重程度似乎是慢性PTSD持续不缓解的主要危险因素。
