Johnson David Read, Fontana Alan, Lubin Hadar, Corn Barbara, Rosenheck Robert
Post Traumatic Stress Center, 19 Edwards Street, New Haven, CT 06511, USA.
J Nerv Ment Dis. 2004 Jan;192(1):35-41. doi: 10.1097/01.nmd.0000105998.90425.6a.
This study is a 6-year longitudinal study of 51 treatment-seeking male veterans with combat-related posttraumatic stress disorder. Measures of PTSD and psychiatric symptomatology, social functioning, and program impact were assessed at admission to an inpatient treatment program, at 18 months, and 6 years later. Previous studies had shown that the treatment program's impact on course of illness had been negligible. The sample showed an extremely high mortality rate of 17% over 6 years. The remaining veterans showed improvement in violence and alcohol and drug use, but an increase in hyperarousal symptoms and social isolation. Nearly three-fourths had had an inpatient hospitalization. Veterans' self-ratings, in contrast, indicated significant improvement in all areas of functioning except employment, as well as an overall positive view of the impact of the program on their lives. Results indicate that the majority of the veteran sample had experienced some improvement in their ability to cope with their chronic illness, decreasing their use of violence and substance abuse but still were experiencing high levels of symptomatology. The extremely high mortality rate, however, provides a somber reminder of the seriousness of this disorder.
本研究是一项针对51名寻求治疗的患有与战斗相关创伤后应激障碍的男性退伍军人的为期6年的纵向研究。在进入住院治疗项目时、18个月时以及6年后，对创伤后应激障碍和精神症状学、社会功能以及项目影响进行了评估。先前的研究表明，该治疗项目对病程的影响微乎其微。样本显示，6年间的死亡率极高，达17%。其余退伍军人在暴力行为以及酒精和药物使用方面有所改善，但过度警觉症状和社会隔离有所增加。近四分之三的人曾住院治疗。相比之下，退伍军人的自我评估表明，除就业外，所有功能领域均有显著改善，并且对该项目对其生活的影响总体持积极看法。结果表明，大多数退伍军人样本在应对慢性病的能力方面有了一些改善，减少了暴力行为和药物滥用，但仍有高水平的症状。然而，极高的死亡率沉痛地提醒人们这种疾病的严重性。
