Koren Danny, Arnon Isaac, Lavie Peretz, Klein Ehud
Department of Psychiatry, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa.
Am J Psychiatry. 2002 May;159(5):855-7. doi: 10.1176/appi.ajp.159.5.855.
Disturbed sleep is a common complaint among patients with posttraumatic stress disorder (PTSD) that appears in the reexperiencing and hyperarousal symptom clusters in DSM-IV. The causal relationship between sleep complaints and PTSD is unclear.
Self-reported insomnia and excessive daytime sleepiness were assessed in 102 victims of motor vehicle accidents and 19 comparison subjects 1 week and 1, 3, 6, and 12 months after the trauma. At 12 months the Structured Clinical Interview for DSM-III-R was administered to determine diagnoses of PTSD.
Twenty-six of the accident victims but none of the comparison subjects met the criteria for PTSD. Logistic regression models indicated that sleep complaints from 1 month on were significant in predicting PTSD at 1 year.
These results suggest that on the basis of sleep complaints as early as 1 month after the trauma, it is possible to detect subjects who will later develop chronic PTSD.
睡眠障碍是创伤后应激障碍（PTSD）患者的常见主诉，在《精神疾病诊断与统计手册》第四版（DSM-IV）的反复体验和过度警觉症状群中有所体现。睡眠主诉与PTSD之间的因果关系尚不清楚。
在102名机动车事故受害者和19名对照受试者中，于创伤后1周、1个月、3个月、6个月和12个月评估自我报告的失眠和日间过度嗜睡情况。在12个月时，采用《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）结构化临床访谈来确定PTSD诊断。
26名事故受害者符合PTSD标准，而对照受试者无人符合。逻辑回归模型表明，创伤后1个月起的睡眠主诉对预测1年后的PTSD具有显著意义。
这些结果表明，基于创伤后1个月时的睡眠主诉，有可能检测出日后会发展为慢性PTSD的受试者。
