Zlotnick Caron, Franklin C Laurel, Zimmerman Mark
Department of Psychiatry and Human Behavior, Rhode Island Hospital, Brown University, Providence, RI 02906, USA.
Compr Psychiatry. 2002 Nov-Dec;43(6):413-9. doi: 10.1053/comp.2002.35900.
The present report examined the extent to which subthreshold posttraumatic stress disorder (PTSD) (without lifetime PTSD) and full PTSD are associated with impairment or distress, controlling for comorbidity (i.e., major depression and panic disorder) in a sample of treatment-seeking psychiatric patients. Patients were administered diagnostic interviews and assessed for psychosocial impairment and whether or not they desired treatment for their PTSD symptoms. No significant differences were found between patients with full PTSD (N = 156) and those with subthreshold PTSD (N = 56) in degree of impairment (i.e., social and work functioning, as well as number of suicide attempts). In contrast, those with full PTSD had significantly more psychiatric hospitalizations and worse global functioning and were more likely to want treatment for their PTSD symptoms compared to those with subthreshold PTSD, albeit the majority of patients with subthreshold PTSD wanted treatment for their PTSD symptoms. These findings, like past research, suggest that subthreshold PTSD is associated with levels of social and work morbidity comparable to full PTSD. However, the report also underscores the difficulties in identifying a set of clinical criteria that clearly delineates between full PTSD and subthreshold PTSD.
本报告研究了阈下创伤后应激障碍（PTSD）（无终生PTSD）和完全PTSD与损害或痛苦的关联程度，同时在寻求治疗的精神科患者样本中控制了共病情况（即重度抑郁症和惊恐障碍）。对患者进行了诊断访谈，并评估了其心理社会损害情况以及他们是否希望针对PTSD症状进行治疗。在损害程度（即社会和工作功能，以及自杀未遂次数）方面，完全PTSD患者（N = 156）和阈下PTSD患者（N = 56）之间未发现显著差异。相比之下，完全PTSD患者的精神病住院次数显著更多，整体功能更差，且与阈下PTSD患者相比，更有可能希望针对其PTSD症状进行治疗，尽管大多数阈下PTSD患者也希望针对其PTSD症状进行治疗。与过去的研究一样，这些发现表明阈下PTSD与完全PTSD的社会和工作发病率水平相当。然而，该报告也强调了确定一套能够清晰区分完全PTSD和阈下PTSD的临床标准存在困难。
