Kuch K, Cox B J
Anxiety Disorders Clinic, Clarke Institute of Psychiatry, University of Toronto, Ont., Canada.
Am J Psychiatry. 1992 Mar;149(3):337-40. doi: 10.1176/ajp.149.3.337.
Survivors of the Holocaust are expected to be at risk for posttraumatic stress disorder (PTSD), but few empirical data are available. This study investigated PTSD symptoms in Holocaust survivors with well-documented exposure to trauma.
The German files of 124 Jewish Holocaust survivors who were judged to be free from bipolar affective disorder, obsessive-compulsive disorder, and organic brain syndrome were selected from those of 145 applicants to West German compensation boards. The psychiatric assessments were reexamined for explicit descriptions of current PTSD symptoms according to the DSM-III-R diagnostic criteria. A subgroup of 20 Auschwitz survivors with tattooed identification numbers were also compared with the 45 survivors who had not been in concentration camps.
Sixty-three percent of the total sample had been detained in concentration camps, and an average of 78% of their first-degree relatives were reported killed in the Holocaust. Forty-six percent of the total sample met the DSM-III-R criteria for PTSD. The most common symptoms were sleep disturbance, recurrent nightmares, and intense distress over reminders. The tattooed Auschwitz survivors had significantly more symptoms and were three times more likely to meet diagnostic criteria for PTSD than the survivors who had not been in concentration camps.
The results suggest a greater risk of chronic PTSD in survivors who were exposed to atrocities. Most survivors had not received adequate psychiatric care.
大屠杀幸存者被认为有患创伤后应激障碍（PTSD）的风险，但实证数据很少。本研究调查了有充分记录表明遭受过创伤的大屠杀幸存者的PTSD症状。
从145名向西德赔偿委员会申请赔偿者的档案中，挑选出124名被判定没有双相情感障碍、强迫症和器质性脑综合征的犹太大屠杀幸存者的德国档案。根据《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）的诊断标准，重新检查精神病学评估，以明确描述当前的PTSD症状。还将20名有纹身识别号码的奥斯威辛集中营幸存者亚组与45名未被关押在集中营的幸存者进行了比较。
总样本中有63%曾被关押在集中营，据报告他们的一级亲属平均有78%在大屠杀中丧生。总样本中有46%符合DSM-III-R的PTSD标准。最常见的症状是睡眠障碍、反复出现噩梦以及对提示物产生强烈痛苦反应。有纹身的奥斯威辛集中营幸存者症状明显更多，符合PTSD诊断标准的可能性是未被关押在集中营的幸存者的三倍。
结果表明，遭受暴行的幸存者患慢性PTSD的风险更大。大多数幸存者没有得到足够的精神科护理。
