van Zelst Willeke H, de Beurs Edwin, Beekman Aartjan T F, Deeg Dorly J H, van Dyck Richard
Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Psychother Psychosom. 2003 Nov-Dec;72(6):333-42. doi: 10.1159/000073030.
Posttraumatic stress disorder (PTSD) has scarcely been researched in the elderly. There is no population-based information on prevalence and risk factors in older persons. Patients with PTSD are often not recognized or incorrectly diagnosed. As the disorder has great implications for the quality of life, a correct diagnosis and treatment are crucial. Increased knowledge on vulnerability factors for PTSD can facilitate diagnostic procedures and health management in the elderly.
PTSD cases were found following a two-phase sampling procedure: a random selection of 1,721 subjects were screened and in 422 subjects a psychiatric diagnostic interview was administered. Prevalence of PTSD and subthreshold PTSD were calculated. Vulnerability factors regarding demographics, physical health, personality, social factors, recent distress and adverse events in early childhood were assessed.
6-month prevalence of PTSD and of subthreshold PTSD was 0.9 and 13.1%, respectively. The strongest vulnerability factors for both PTSD and subthreshold PTSD were neuroticism and adverse events in early childhood.
This is the first population-based study on PTSD in older persons. With a 6-month prevalence of almost 1% the disease is not rare. Comparisons with younger populations suggest some accumulation of cases among older people reflecting the chronic risk factors, which are found in this study: neuroticism and adverse events in early childhood.
创伤后应激障碍(PTSD)在老年人中的研究极少。目前尚无基于人群的关于老年人患病率及风险因素的信息。PTSD患者常未被识别或诊断错误。由于该疾病对生活质量有重大影响,正确的诊断和治疗至关重要。增加对PTSD易患因素的了解有助于老年人的诊断程序和健康管理。
通过两阶段抽样程序发现PTSD病例:随机选择1721名受试者进行筛查,对其中422名受试者进行精神科诊断访谈。计算PTSD和亚阈值PTSD的患病率。评估人口统计学、身体健康、个性、社会因素、近期困扰以及童年早期不良事件等方面的易患因素。
PTSD和亚阈值PTSD的6个月患病率分别为0.9%和13.1%。PTSD和亚阈值PTSD最强的易患因素是神经质和童年早期的不良事件。
这是第一项基于人群的老年人PTSD研究。该疾病6个月患病率近1%,并不罕见。与年轻人群的比较表明,老年人中病例有一定累积,反映了本研究中发现的慢性风险因素:神经质和童年早期的不良事件。