Sherman Jeffrey J, Carlson Charles R, Wilson John F, Okeson Jeffrey P, McCubbin James A
Department of Oral Medicine, University of Washington School of Dentistry, Box 356370, Seattle, WA 98195, USA.
J Orofac Pain. 2005 Fall;19(4):309-17.
To examine the presence and impact of post-traumatic stress disorder (PTSD) in a sample of patients seeking treatment for orofacial pain.
One hundred forty-one consecutive patients with an array of orofacial pain conditions were screened using a structured clinical interview for PTSD and the PTSD Symptom Checklist--Civilian Version (PCL), a brief PTSD self-report inventory. Additionally, participants received a clinical examination and self-report questionnaires to assess pain, coping styles, and presence of post-traumatic symptoms.
Thirty-three (23%) patients received a full lifetime or current PTSD diagnosis, with an additional 11 patients receiving a partial PTSD diagnosis. Only 5 of these 44 patients had ever been previously diagnosed with PTSD. PTSD symptoms were associated with higher pain scores (P < .05) and affective distress (P < .01). Furthermore, discriminant function analyses suggested that the PCL accurately classified 89% of these cases (sensitivity = .85, specificity = .90, positive predictive power = 74%, negative predictive power = 95%).
These results suggest that PTSD is prevalent in the orofacial pain setting and that PTSD symptomatology is associated with increased pain and affective distress that may complicate clinical presentation. Furthermore, PTSD can be accurately and efficiently assessed using a brief, self-report inventory.
研究创伤后应激障碍(PTSD)在寻求口面部疼痛治疗的患者样本中的存在情况及其影响。
使用PTSD结构化临床访谈和PTSD症状清单——平民版(PCL,一种简短的PTSD自我报告量表),对141例患有一系列口面部疼痛疾病的连续患者进行筛查。此外,参与者接受临床检查和自我报告问卷,以评估疼痛、应对方式和创伤后症状的存在情况。
33例(23%)患者被诊断为终身或当前患有PTSD,另有11例患者被诊断为部分PTSD。这44例患者中只有5例曾被诊断患有PTSD。PTSD症状与较高的疼痛评分(P <.05)和情感困扰(P <.01)相关。此外,判别函数分析表明,PCL准确分类了89%的病例(敏感性 =.85,特异性 =.90,阳性预测值 = 74%,阴性预测值 = 95%)。
这些结果表明,PTSD在口面部疼痛患者中普遍存在,且PTSD症状与疼痛加剧和情感困扰相关,这可能使临床表现复杂化。此外,使用简短的自我报告量表可以准确有效地评估PTSD。