Dobie Dorcas J, Kivlahan Daniel R, Maynard Charles, Bush Kristen R, Davis Tania M, Bradley Katharine A
Departments of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA.
Arch Intern Med. 2004 Feb 23;164(4):394-400. doi: 10.1001/archinte.164.4.394.
The purpose of this report is to identify self-reported health problems and functional impairment associated with screening positive for posttraumatic stress disorder (PTSD) in women seen for care at a Department of Veterans Affairs (VA) medical center.
A survey was mailed to all women (N = 1935) who received care at the VA Puget Sound Health Care System between October 1996 and January 1998. The survey inquired about health history and habits. It included the PTSD Checklist-Civilian Version (PCL-C) and validated screening measures for other psychiatric disorders. The veteran's version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36-V) was included to assess health-related quality of life.
Of the 1259 eligible women who completed the survey, 266 women (21%) screened positive for current PTSD (PCL-C score >or= 50). In age-adjusted bivariate analyses, women who screened positive for PTSD reported more psychiatric problems, substance abuse, and lifetime exposure to domestic violence. They were significantly more likely to endorse physical health problems including obesity, smoking, irritable bowel syndrome, fibromyalgia, chronic pelvic pain, polycystic ovary disease, asthma, cervical cancer, and stroke. In fully adjusted multivariate models, a PCL-C score of 50 or greater was independently associated with scoring in the lowest quartile on SF-36-V subscales and composite scales.
Symptoms of PTSD are common in women treated at VA facilities. In addition, PTSD is associated with self-reported mental and physical health problems and poor health-related quality of life in these patients. These findings have implications for the design of VA primary care services for the growing population of female veterans.
本报告旨在确定在退伍军人事务部（VA）医疗中心接受治疗的女性中，与创伤后应激障碍（PTSD）筛查呈阳性相关的自我报告的健康问题和功能损害。
向1996年10月至1998年1月期间在VA普吉特海湾医疗保健系统接受治疗的所有女性（N = 1935）邮寄了一份调查问卷。该调查询问了健康史和生活习惯。它包括创伤后应激障碍检查表-平民版（PCL-C）以及针对其他精神障碍的有效筛查措施。还纳入了退伍军人版的医学结果研究36项简短健康调查（SF-36-V）以评估与健康相关的生活质量。
在完成调查的1259名符合条件的女性中，有266名女性（21%）目前PTSD筛查呈阳性（PCL-C评分≥50）。在年龄调整的双变量分析中，PTSD筛查呈阳性的女性报告有更多的精神问题、药物滥用以及一生中有过家庭暴力经历。她们更有可能认可存在身体健康问题，包括肥胖、吸烟、肠易激综合征、纤维肌痛、慢性盆腔疼痛、多囊卵巢疾病、哮喘、宫颈癌和中风。在完全调整的多变量模型中，PCL-C评分50或更高与SF-36-V子量表和综合量表得分处于最低四分位数独立相关。
PTSD症状在VA机构治疗的女性中很常见。此外，PTSD与这些患者自我报告的身心健康问题以及较差的与健康相关的生活质量相关。这些发现对为不断增加的女性退伍军人设计VA初级保健服务具有启示意义。
