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一级创伤中心的创伤后应激障碍、酒精障碍和反复创伤

Posttraumatic distress, alcohol disorders, and recurrent trauma across level 1 trauma centers.

作者信息

Zatzick Douglas, Jurkovich Gregory, Russo Joan, Roy-Byrne Peter, Katon Wayne, Wagner Amy, Dunn Chris, Uehara Edwina, Wisner David, Rivara Frederick

机构信息

Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, Washington 98104-2499, USA.

出版信息

J Trauma. 2004 Aug;57(2):360-6. doi: 10.1097/01.ta.0000141332.43183.7f.

Abstract

BACKGROUND

Injured survivors of individual and mass trauma receive their initial evaluation in acute care. Few investigations have comprehensively screened for posttraumatic stress disorder (PTSD) symptoms and related comorbidities across sites.

METHODS

This investigation included 269 randomly selected injury survivors hospitalized at two level 1 trauma centers. All patients were screened for PTSD, depressive, and peritraumatic dissociative symptoms during their surgical inpatient admission. Prior traumatic life events and alcohol abuse/dependence also were assessed.

RESULTS

In this study, 58% of the patients demonstrated high levels of immediate posttraumatic distress or alcohol abuse/dependence. Regression analyses identified greater prior trauma, female gender, nonwhite ethnicity, and site as significant independent predictors for high levels of posttraumatic distress.

CONCLUSIONS

High levels of posttraumatic distress, recurrent trauma, and alcohol abuse/dependence were present in more than half of acute care inpatients. Early mental health screening and intervention procedures that target both PTSD and alcohol use should be developed for acute care settings.

摘要

背景

个体创伤和群体创伤的受伤幸存者在急诊中接受初步评估。很少有研究全面筛查不同地点的创伤后应激障碍(PTSD)症状及相关共病情况。

方法

本研究纳入了在两家一级创伤中心住院的269名随机选取的受伤幸存者。所有患者在外科住院期间均接受了PTSD、抑郁及创伤期间分离症状的筛查。还评估了既往创伤性生活事件及酒精滥用/依赖情况。

结果

在本研究中,58%的患者表现出高水平的创伤后即时痛苦或酒精滥用/依赖。回归分析确定,更多的既往创伤、女性性别、非白人种族及地点是创伤后痛苦高水平的显著独立预测因素。

结论

超过半数的急诊住院患者存在高水平的创伤后痛苦、反复创伤及酒精滥用/依赖。应为急诊环境制定针对PTSD和酒精使用的早期心理健康筛查及干预程序。

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